Karim Birry, Nasution Sally A, Wijaya Ika P, Harimurti Kuntjoro
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2015 Oct;47(4):320-5.
to investigate the MACE-free survivals difference between hyperuricemic and normouricemic patients and to determine its role as risk factor for MACE occurrence in hospitalized acute coronary syndrome patients.
retrospective cohort study with survival analysis approach was conducted in 251 patients with acute coronary syndrome who were treated in ICCU Cipto Mangunkusumo Hospital during period from January 2009 to December 2011. Clinical data, laboratory results, electrocardiography result, echocardiography result, and coronary angiography were collected. Patients were observed and followed on major adverse cardiac event during 7 days of hospitalization in ICCU. Major adverse Cardiac Event is an event as a complication occur after acute coronary syndrome such as cardiogenic syock, acute heart failure, stoke, reinfarct during early ward treatment, sudden cardiac death, repeat PCI during ward ulang and perform coronary artery bypass graft (CABG) surgery. Difference in survival is shown in Kaplan-meier curve and difference in survival between groups were tested with Log-rank test, and multivariate analysis with Cox proportional hazard regression to calculate adjusted HR on major adverse cardiac event with confounding variables as covariates.
there was a significant difference in survival between hyperuricemia group and non-hyperuricemia group (Log-rank test (p<0.001)) with crude HR 2.7 (CI 95% 1.6-4) and adjusted HR 2.67 (CI 95% 1.6-4.3).There was significant difference in survival between hyperuricemia group (mean survival 6.05 days with SE 0.2 (CI 95% 5.6-6.4) and non-hyperuricemia group (mean survival 7.33 days with SE 0.1 (CI 95% 7.0-7.6).
survival of patients suffering from ACS with hyperuricemia is worse compared to those without hyperuricemia during ICCU hospitalization.
探讨高尿酸血症患者与非高尿酸血症患者无主要不良心血管事件生存期的差异,并确定其作为住院急性冠状动脉综合征患者发生主要不良心血管事件风险因素的作用。
采用生存分析方法对2009年1月至2011年12月期间在西爪哇省芝多阿索莫医院ICCU接受治疗的251例急性冠状动脉综合征患者进行回顾性队列研究。收集临床资料、实验室检查结果、心电图结果、超声心动图结果和冠状动脉造影资料。在ICCU住院7天期间观察并随访患者的主要不良心脏事件。主要不良心脏事件是急性冠状动脉综合征后发生的并发症,如心源性休克、急性心力衰竭、中风、早期病房治疗期间的再梗死、心源性猝死、病房复查期间重复进行经皮冠状动脉介入治疗(PCI)以及进行冠状动脉旁路移植术(CABG)手术。生存差异用Kaplan-meier曲线表示,组间生存差异用Log-rank检验进行检验,并采用Cox比例风险回归进行多变量分析,以计算调整后的主要不良心脏事件风险比(HR),将混杂变量作为协变量。
高尿酸血症组与非高尿酸血症组的生存率存在显著差异(Log-rank检验(p<0.001)),粗风险比(HR)为2.7(95%可信区间[CI]1.6 - 4),调整后的HR为2.67(95%CI 1.6 - 4.3)。高尿酸血症组(平均生存期6.05天,标准误0.2(95%CI 5.6 - 6.4))与非高尿酸血症组(平均生存期7.33天,标准误0.1(95%CI 7.0 - 7.6))的生存率存在显著差异。
在ICCU住院期间,患有急性冠状动脉综合征的高尿酸血症患者的生存率低于非高尿酸血症患者。