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高尿酸血症与老年急性心肌梗死患者的短期预后相关。

Hyperuricemia is associated with short-term outcomes in elderly patients with acute myocardial infarction.

机构信息

Tangshan Gongren Hospital, Tangshan, Hebei, China.

Sichuan University, Chengdu, Sichuan, China.

出版信息

Aging Clin Exp Res. 2018 Oct;30(10):1211-1215. doi: 10.1007/s40520-018-0903-3. Epub 2018 Feb 6.

Abstract

BACKGROUND

Although a lot of studies have  shown serum uric acid (SUA) could be a marker of adverse prognosis in patients with acute myocardial infarction, the role of SUA as a risk factor for myocardial infarction is controversial. This study aimed to evaluate the association between hyperuricemia and short-term outcomes of elderly patients with acute ST-segment elevation myocardial infarction (STEMI).

METHODS

Six hundred and seventy-three elderly patients (≥ 60 years) were divided into high-SUA-level group (group H: N = 168) and low-SUA-level group (group L: N = 505) according to the SUA levels on admission. The following primary end points were evaluated within 30 days of AMI. The adverse events included postoperative angina pectoris, heart failure (Killip class ≥ II), and death. The comparisons were made between two groups in clinical and angiographic characteristics.

RESULTS

The incidences of postoperative angina pectoris, heart failure, and the total adverse cardiovascular events were significantly higher in group H than in group L. But the incidence of death was similar between groups. In group H, heart rate (HR), systolic and diastolic blood pressure, SUA, homocysteine (HCY), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and creatine kinase myocardial band (CKMB) peak were clearly higher compared with those in group L. The results of logistic regression showed that the incidence of 30-day adverse events was closely related to TG, HCY and SUA.

CONCLUSIONS

An elevated SUA level may be related to the short-term outcomes and seems to be an independent predictor of 30-day cardiovascular events in elderly patients with STEMI.

摘要

背景

尽管大量研究表明血清尿酸(SUA)可作为急性心肌梗死患者不良预后的标志物,但 SUA 作为心肌梗死危险因素的作用仍存在争议。本研究旨在评估老年急性 ST 段抬高型心肌梗死(STEMI)患者高尿酸血症与短期预后的关系。

方法

根据入院时的 SUA 水平,将 673 例老年(≥60 岁)患者分为高 SUA 水平组(组 H:N=168)和低 SUA 水平组(组 L:N=505)。在 AMI 后 30 天内评估以下主要终点。不良事件包括术后心绞痛、心力衰竭(Killip 分级≥II)和死亡。比较两组的临床和血管造影特征。

结果

组 H 的术后心绞痛、心力衰竭和总不良心血管事件发生率明显高于组 L,但组间死亡率相似。在组 H 中,心率(HR)、收缩压和舒张压、SUA、同型半胱氨酸(HCY)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和肌酸激酶同工酶 MB 峰明显高于组 L。Logistic 回归结果表明,30 天不良事件的发生率与 TG、HCY 和 SUA 密切相关。

结论

SUA 水平升高可能与短期预后有关,似乎是老年 STEMI 患者 30 天心血管事件的独立预测因子。

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