Ozsu Savas, Çoşar Arif M, Aksoy Hayriye Bektas, Bülbül Yilmaz, Oztuna Funda, Karahan S Caner, Ozlu Tevfik
Department of Pulmonary Medicine
Department of Gastroenterology.
Respir Care. 2017 Aug;62(8):1091-1096. doi: 10.4187/respcare.05433. Epub 2017 Jun 20.
Pulmonary thromboembolism is a serious cardiovascular condition with considerable morbidity and mortality. Clinical studies have indicated that hyperuricemia is an independent risk factor for cardiovascular events. The aim of this study was to investigate possible value of the serum levels of uric acid (UA) in predicting 30-d pulmonary thromboembolism-related mortality.
Pulmonary thromboembolism was confirmed by computed tomography pulmonary angiography, demographic data, troponin, systolic pressure and pulse on admission, and simplified pulmonary embolism severity index assessment. UA levels were analyzed on admission. The primary end point was all-cause mortality during the first 30 d.
A total of 337 acute pulmonary thromboembolism subjects, of whom 59% were females, were enrolled. The median (interquartile range) serum UA level was 5.35 (4.1-7.3) mg/dL. Serum UA levels of deceased subjects were higher than those of alive subjects during the study period (6.9 [4.6-10.0] mg/dL vs 5.2 [4.1-7.0] mg/dL, = .038). In the receiver operating characteristic analysis, the area under the curve was 0.650 (CI 0.732-0.960) for UA levels for all-cause mortality. A level of serum UA ≥ 5 mg/dL showed 73% sensitivity and 88% negative predictive value for all-cause 30-d mortality. A weak correlation was determined between the UA levels and age (r = 0.25, < .001) and any troponin (r = 0.267, < .001). Serum UA level was an independent predictor of short-term mortality in pulmonary thromboembolism (odds ratio 1.2, = .002).
Serum UA levels may be a potential biomarker for predicting outcome in patients with acute pulmonary thromboembolism.
肺血栓栓塞是一种严重的心血管疾病，具有较高的发病率和死亡率。临床研究表明，高尿酸血症是心血管事件的独立危险因素。本研究的目的是探讨血清尿酸（UA）水平在预测30天肺血栓栓塞相关死亡率方面的可能价值。
通过计算机断层扫描肺动脉造影、人口统计学数据、肌钙蛋白、入院时的收缩压和脉搏以及简化的肺栓塞严重指数评估来确诊肺血栓栓塞。入院时分析UA水平。主要终点是前30天内的全因死亡率。
共纳入337例急性肺血栓栓塞患者，其中59%为女性。血清UA水平的中位数（四分位间距）为5.35（4.1 - 7.3）mg/dL。在研究期间，死亡患者的血清UA水平高于存活患者（6.9 [4.6 - 10.0] mg/dL对5.2 [4.1 - 7.0] mg/dL，P = 0.038）。在受试者工作特征分析中，UA水平预测全因死亡率的曲线下面积为0.650（95%CI 0.732 - 0.960）。血清UA≥5 mg/dL对30天全因死亡率的敏感性为73%，阴性预测值为88%。UA水平与年龄（r = 0.25，P < 0.001）和任何肌钙蛋白（r = 0.267，P < 0.001）之间存在弱相关性。血清UA水平是肺血栓栓塞短期死亡率的独立预测因素（比值比1.2，P = 0.002）。
血清UA水平可能是预测急性肺血栓栓塞患者预后的潜在生物标志物。
