Dyrbuś Maciej, Desperak Piotr, Pawełek Marta, Możdżeń Mateusz, Gąsior Mariusz, Hawranek Michał
Student Scientific Society, 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
Cardiol J. 2021 Dec 13;30(6):984-94. doi: 10.5603/CJ.a2021.0156.
The data on the association between serum uric acid (sUA) concentration and outcomes in patients with an ACS are inconsistent and do not focus on patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). The aim of this study was to analyze an association of sUA concentration on admission and outcomes in those patients.
Data from the prospective, single-center registry of patients hospitalized due to NSTE-ACS from January 2006 to December 2016 were analyzed retrospectively. The population was divided into quartiles according to the baseline sUA. The primary outcome was the incidence of all-cause death, non-fatal myocardial infarction, stroke and ACS-driven revascularization at 36 months.
Total of 2,824 patients with sUA measured on admission were included in this analysis with a median sUA of 352 µmol/L (5.92 mg/dL). Patients with higher sUA were older and more burdened with cardiovascular risk factors and history of coronary events. The prevalence of multivessel coronary artery disease and left main stenosis was significantly higher in patients with higher sUA. Elevated sUA concentration was associated with significantly worse short-, mid- and long-term outcomes. All-cause mortality was significantly higher in each analyzed period. In the multivariable analysis, sUA elevation was identified as an independent predictor of all-cause mortality at 12-month and 36-month follow-up.
Elevated baseline sUA concentration was independently associated with worse mid- and long-term outcomes in patients with NSTE-ACS. Baseline sUA concentration could identify patients with NSTE-ACS at higher risk of more dismal prognosis.
关于血清尿酸（sUA）浓度与急性冠状动脉综合征（ACS）患者预后之间关联的数据并不一致，且未聚焦于非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者。本研究旨在分析这些患者入院时sUA浓度与预后的关联。
回顾性分析了2006年1月至2016年12月因NSTE-ACS住院患者的前瞻性单中心登记数据。根据基线sUA将人群分为四分位数。主要结局是36个月时全因死亡、非致命性心肌梗死、中风和ACS驱动的血运重建的发生率。
本分析纳入了2824例入院时测量了sUA的患者，sUA中位数为352 µmol/L（5.92 mg/dL）。sUA较高的患者年龄更大，心血管危险因素和冠状动脉事件病史负担更重。sUA较高的患者多支冠状动脉疾病和左主干狭窄的患病率显著更高。sUA浓度升高与短期、中期和长期预后显著更差相关。各分析时间段内全因死亡率均显著更高。在多变量分析中，sUA升高被确定为12个月和36个月随访时全因死亡的独立预测因素。
基线sUA浓度升高与NSTE-ACS患者更差的中期和长期预后独立相关。基线sUA浓度可识别NSTE-ACS预后更差风险更高的患者。
