Department of CCU, The No.6 People's Hospital, Huizhou, China.
Department of CCU, Huiyang Hospital Affiliated Southern Medical University, Huizhou, China.
Eur J Clin Invest. 2019 Apr;49(4):e13074. doi: 10.1111/eci.13074. Epub 2019 Feb 25.
The prognostic significance of elevated circulating uric acid level in patients with acute coronary syndrome (ACS) is conflicting. This meta-analysis aimed to assess the prognostic value of hyperuricemia in patients with ACS.
A comprehensive literature search was performed in Pubmed, Embase, VIP, CNKI and WanFang databases up to 16 June 2018. All observational studies that investigated the prognostic value of hyperuricemia in ACS patients were selected. Outcome of interests was major adverse cardiovascular events (MACEs), all-cause mortality or cardiovascular mortality.
A total of nine studies enrolling 8776 ACS patients were included and analysed. ACS patients with hyperuricemia had an increased risk of MACEs (risk ratio [RR]: 1.86; 95% confidence intervals [CI]: 1.47-2.35), all-cause mortality (RR 1.86; 95% CI: 1.49-2.32) and cardiovascular mortality (RR: 1.74; 95% CI: 1.36-2.22) after adjustment for the conventional risk factors. Stratified analysis showed that the prognostic significance of hyperuricemia was consistently observed in each subgroups.
This meta-analysis suggests that hyperuricemia independently predicts MACEs and death in ACS patients. Determination of uric acid level has potential to improve risk stratification of adverse outcomes in ACS patients.
在急性冠脉综合征（ACS）患者中，循环尿酸水平升高的预后意义存在争议。本荟萃分析旨在评估高尿酸血症在 ACS 患者中的预后价值。
我们在 Pubmed、Embase、VIP、CNKI 和 WanFang 数据库中进行了全面的文献检索，检索时间截至 2018 年 6 月 16 日。所有纳入的观察性研究均调查了 ACS 患者高尿酸血症的预后价值。主要终点是主要不良心血管事件（MACEs）、全因死亡率或心血管死亡率。
共纳入 9 项研究，共计 8776 例 ACS 患者。校正传统危险因素后，高尿酸血症患者发生 MACEs（风险比 [RR]：1.86；95%置信区间 [CI]：1.47-2.35）、全因死亡率（RR 1.86；95% CI：1.49-2.32）和心血管死亡率（RR：1.74；95% CI：1.36-2.22）的风险增加。分层分析显示，高尿酸血症的预后意义在各亚组中均一致存在。
本荟萃分析表明，高尿酸血症独立预测 ACS 患者的 MACEs 和死亡。尿酸水平的测定有可能改善 ACS 患者不良结局的风险分层。
