Division of Endocrinology, Diabetology, Nephrology, Vascular Disease, and Clinical Chemistry, Department of Internal Medicine, Eberhard-Karls-University Tübingen, Tübingen, Germany.
Nutr Metab Cardiovasc Dis. 2013 Jan;23(1):46-52. doi: 10.1016/j.numecd.2011.02.008. Epub 2011 Jun 23.
High serum uric acid (SUA) is suggested to be causally involved in the pathogenesis of vascular disease. The present study aimed to investigate whether SUA independently predicts all-cause mortality, cardiovascular mortality and sudden cardiac death in subjects scheduled for coronary angiography.
We studied participants of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study. A total of 3245 individuals were included in the analysis. There was a follow-up for all-cause mortality, cardiovascular mortality, and sudden cardiac death with a mean (±standard deviation) duration of 7.3 (±2.3) years. Sex-specific quartiles of SUA were established and multivariate statistical models were used. A total of 730 deaths occurred during the follow-up. Among these, 473 (64.8%) were accounted for by cardiovascular diseases. Sudden cardiac death occurred in 184 (25.2%) cases. Adjusting for sex and age subjects in the fourth SUA quartile had increased all-cause (hazard ratio (HR) = 1.68, p < 0.001) and cardiovascular (HR = 2.00, p < 0.001) mortality compared to individuals in the first quartile. Furthermore, high SUA was a risk factor for sudden cardiac death (HR = 2.27, p < 0.001). These associations remained significant including cardiovascular risk factors and the severity of coronary atherosclerosis as covariates in the models. After additional adjustment for medication use statistical significance for the association between the SUA quartiles and all-cause mortality disappeared.
High SUA independently indicates increased risk for cardiovascular and sudden cardiac death in subjects referred for coronary angiography.
高血清尿酸（SUA）被认为与血管疾病的发病机制有关。本研究旨在探讨在接受冠状动脉造影的患者中，SUA 是否独立预测全因死亡率、心血管死亡率和心源性猝死。
我们研究了 LUdwigshafen RIsk 和心血管健康（LURIC）研究的参与者。共有 3245 人纳入分析。全因死亡率、心血管死亡率和心源性猝死的随访时间平均（±标准差）为 7.3（±2.3）年。建立了 SUA 的性别特异性四分位数，并使用多变量统计模型。在随访期间共发生 730 例死亡，其中 473 例（64.8%）归因于心血管疾病。184 例（25.2%）发生心源性猝死。在调整性别和年龄后，SUA 四分位第 4 组的全因（风险比（HR）=1.68，p <0.001）和心血管（HR=2.00，p <0.001）死亡率均高于第 1 四分位组。此外，高 SUA 是心源性猝死的危险因素（HR=2.27，p <0.001）。这些关联在模型中包括心血管危险因素和冠状动脉粥样硬化严重程度作为协变量时仍然显著。在进一步调整药物使用后，SUA 四分位组与全因死亡率之间的关联失去统计学意义。
在接受冠状动脉造影的患者中，高 SUA 独立提示心血管和心源性猝死风险增加。
