Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
Postgrad Med J. 2020 Feb;96(1132):73-78. doi: 10.1136/postgradmedj-2019-136650. Epub 2019 Sep 5.
The prognostic value of serum uric acid (SUA) for incident acute coronary syndrome (ACS) in hypertensive subjects is uncertain. Therefore, the present study examined the association between SUA and incident ACS in a large cohort of Chinese hypertensive adults.
This was a retrospective cohort study, which enrolled 5473 Chinese community-dwelling hypertensive patients from 1 January 2012 to 31 December 2012. Study outcomes were ACS events, and patients were followed until 31 December 2016. Cox regression analyses were conducted to determine adjusted HRs and 95% CIs for baseline SUA tertiles (low, middle and high group) and for men and women separately.
A total of 5473 participants were included in the analysis (median follow-up was 4.5 years). Participants were divided into tertiles based on SUA levels. During follow-up, 9 (0.49%), 14 (0.77%) and 25 (1.37%) patients developed ACS in the lowest, middle and highest tertiles, respectively. When compared with the lowest tertile of SUA, the highest tertile of SUA was associated with ACS risk in all subjects and in men and women separately (HR: 2.62, 95% CI 1.14 to 7.01, p=0.0233; 2.15, 95% CI 1.08 to 6.04, p=0.021, and 3.49, 95% CI 1.25 to 7.74, p=0.017, respectively).
Higher SUA levels were independently associated with an elevated risk of ACS incidence. The relationship between SUA levels and ACS in hypertensive patients was J-shaped.
血清尿酸（SUA）对高血压患者发生急性冠状动脉综合征（ACS）的预后价值尚不确定。因此，本研究在一个大型中国高血压成年人队列中检验了 SUA 与 ACS 事件的相关性。
这是一项回顾性队列研究，纳入了 2012 年 1 月 1 日至 2012 年 12 月 31 日期间的 5473 名中国社区高血压患者。研究终点为 ACS 事件，随访时间截至 2016 年 12 月 31 日。采用 Cox 回归分析确定基线 SUA 三分位（低、中、高组）和男女患者的调整后的 HRs 和 95%CI。
共有 5473 名参与者纳入分析（中位随访时间为 4.5 年）。参与者根据 SUA 水平分为三分位。随访期间，最低、中、高三分位组分别有 9（0.49%）、14（0.77%）和 25（1.37%）名患者发生 ACS。与 SUA 最低三分位相比，SUA 最高三分位与所有受试者以及男性和女性 ACS 风险均相关（HR：2.62，95%CI 1.14 至 7.01，p=0.0233；2.15，95%CI 1.08 至 6.04，p=0.021；3.49，95%CI 1.25 至 7.74，p=0.017）。
较高的 SUA 水平与 ACS 发生率的升高独立相关。高血压患者中 SUA 水平与 ACS 之间呈 J 型关系。
