Hiraga Takashi, Saito Yuichi, Mori Naoto, Tateishi Kazuya, Kitahara Hideki, Kobayashi Yoshio
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-0856, Japan.
Department of Internal Medicine, Chiba Aoba Municipal Hospital, Chiba 260-0852, Japan.
J Clin Med. 2021 Sep 30;10(19):4530. doi: 10.3390/jcm10194530.
Previous studies indicated that serum uric acid (SUA) level is a marker of endothelial function in subsets of ischemic heart disease (IHD). In the present study, we aimed to evaluate the relation between the SUA level and endothelial function in patients with a broad spectrum of IHD, including obstructive coronary artery disease (CAD) and ischemia with no obstructive CAD (INOCA). Three prospective studies and one retrospective study were pooled, in which the SUA level was measured, and systemic endothelial function was assessed using the reactive hyperemia index (RHI). The primary endpoint of the present study was a correlation of the SUA level with RHI. A total of 181 patients with a broad spectrum of IHD were included, among whom, 46 (25%) had acute coronary syndrome presentation and 15 (8%) had INOCA. Overall, the SUA level was negatively correlated with the RHI (r = -0.22, = 0.003). Multivariable analysis identified the SUA level and INOCA as significant factors associated with RHI values. In conclusion, in patients with a broad spectrum of IHD, including obstructive epicardial CAD (chronic and acute coronary syndromes) and INOCA, the SUA level was significantly and negatively correlated with systemic endothelial function assessed with the RHI. INOCA, rather than obstructive CAD, was more associated with endothelial dysfunction.
既往研究表明，血清尿酸（SUA）水平是缺血性心脏病（IHD）亚组中内皮功能的一个标志物。在本研究中，我们旨在评估SUA水平与广泛类型IHD患者（包括阻塞性冠状动脉疾病（CAD）和无阻塞性CAD的缺血（INOCA））内皮功能之间的关系。我们汇总了三项前瞻性研究和一项回顾性研究，这些研究测量了SUA水平，并使用反应性充血指数（RHI）评估了全身内皮功能。本研究的主要终点是SUA水平与RHI之间的相关性。共纳入了181例广泛类型IHD患者，其中46例（25%）表现为急性冠状动脉综合征，15例（8%）患有INOCA。总体而言，SUA水平与RHI呈负相关（r = -0.22，P = 0.003）。多变量分析确定SUA水平和INOCA是与RHI值相关的显著因素。总之，在包括阻塞性心外膜CAD（慢性和急性冠状动脉综合征）和INOCA在内的广泛类型IHD患者中，SUA水平与用RHI评估的全身内皮功能显著负相关。与内皮功能障碍相关性更强的是INOCA，而非阻塞性CAD。
