Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.
Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.
Am J Cardiol. 2014 Jan 15;113(2):197-202. doi: 10.1016/j.amjcard.2013.09.004. Epub 2013 Oct 2.
Serum uric acid (SUA) level is known as a significant predictor for cardiovascular diseases, partly through increased inflammatory response and smooth muscle cell proliferation. Inflammation and smooth muscle cells play a crucial role in the pathogenesis of in-stent restenosis (ISR). However, the relation between SUA and ISR has not been studied. The aim of the present study was to investigate the predictive value of preprocedural SUA on the development of ISR in patients who undergo coronary bare-metal stent implantation. Clinical, biochemical, and angiographic data from 708 consecutive patients (mean age 60.3 ± 9.3 years, 71% men) who had undergone bare-metal stent implantation and additional control coronary angiography for stable or unstable angina pectoris were analyzed. Patients were divided into tertiles on the basis of preprocedural SUA levels. Stent restenosis was observed in 54 patients (23%) in the lowest tertile, in 79 (34%) in the middle tertile, and in 109 (46%) in the highest tertile (p <0.001). Using multiple logistic regression analysis, diabetes mellitus, smoking, high-density lipoprotein cholesterol, stent length, C-reactive protein level, and preprocedural SUA level emerged as independent predictors of ISR. On receiver-operating characteristics curve analysis, SUA level >5.5 mg/dl had 75% sensitivity and 71% specificity (area under the curve 0.784, p <0.001) in predicting ISR. In conclusion, higher preprocedural SUA is a powerful and independent predictor of bare-metal stent restenosis in patients with stable and unstable angina pectoris.
血清尿酸（SUA）水平被认为是心血管疾病的重要预测指标，部分原因是其可引起炎症反应和血管平滑肌细胞增殖增加。炎症和血管平滑肌细胞在支架内再狭窄（ISR）的发病机制中起关键作用。然而，SUA 与 ISR 之间的关系尚未得到研究。本研究旨在探讨经皮冠状动脉裸金属支架置入术（BMS）前 SUA 对稳定型和不稳定型心绞痛患者 ISR 发展的预测价值。分析了 708 例连续接受 BMS 治疗并因稳定型或不稳定型心绞痛进行额外冠状动脉造影的患者的临床、生化和血管造影数据（平均年龄 60.3±9.3 岁，71%为男性）。根据术前 SUA 水平将患者分为 3 组。在最低三分位组中，54 例（23%）患者出现支架再狭窄，中间三分位组中，79 例（34%）患者出现支架再狭窄，最高三分位组中，109 例（46%）患者出现支架再狭窄（p<0.001）。采用多因素 logistic 回归分析，糖尿病、吸烟、高密度脂蛋白胆固醇、支架长度、C 反应蛋白水平和术前 SUA 水平是 ISR 的独立预测因子。在受试者工作特征曲线分析中，SUA 水平>5.5mg/dl 预测 ISR 的敏感性为 75%，特异性为 71%（曲线下面积 0.784，p<0.001）。结论：在稳定型和不稳定型心绞痛患者中，较高的术前 SUA 是 BMS 再狭窄的有力且独立的预测因子。
