无症状高尿酸血症对择期经皮冠状动脉介入治疗后老年患者死亡率的影响。
Effect of Asymptomatic Hyperuricemia on Mortality of Elderly Patients After Elective Percutaneous Coronary Intervention.
作者信息
Chen Chen, Dong Jianzeng, Lv Qiang, Liu Xinmin, Zhang Qian, Du Xin
机构信息
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
出版信息
Front Cardiovasc Med. 2022 Mar 17;9:800414. doi: 10.3389/fcvm.2022.800414. eCollection 2022.
PURPOSE
The purpose of this study is to investigate the effect of asymptomatic hyperuricemia on mortality of elderly patients with coronary artery disease (CAD) after elective percutaneous coronary intervention (PCI).
METHODS
One thousand two hundred ninety-six patients with coronary heart disease ≥65 years old who had increased uric acid records and without gout history underwent elective PCI from January 2015 to January 2016 were enrolled. The hyperuricemia is defined as serum uric acid level >420 μ mol/l (7 mg/dl) for males and >357 μ mol/l (6 mg/dl) for females. Patients were divided into hyperuricemia group and non-hyperuricemia group. After an average of 519 days follow-up, the differences in mortality between the two groups were compared.
RESULTS
There were 236 patients in hyperuricemia group and 1060 patients in non-hyperuricemia group. In hyperuricemia group, BMI was higher ( = 0.036); the proportions of patients with hypertension ( < 0.001) and myocardial infarction history ( = 0.046) were higher; white blood cells ( = 0.015) and triglyceride levels were higher ( < 0.001); and estimated glomerular filtration rate ( < 0.001) and high-density lipoprotein cholesterol level were lower ( = 0.007). In addition, in hyperuricemia group, during hospitalization, the ratios of patients treated with diuretics ( < 0.001) and the number of PCI lesions were higher ( = 0.030), and the complete revascularization rate was lower ( = 0.017). The mortality rate (2.2 vs. 7.6%, < 0.001) of hyperuricemia group was significantly higher than that of non-hyperuricemia group. Multivariate Cox regression analysis showed that after adjusting for other factors, hyperuricemia was an independent risk factor for increased mortality after PCI (HR 2.786, 95% CI 1.233-6.297, = 0.014).
CONCLUSION
Asymptomatic hyperuricemia is an independent risk factor for increased mortality of elderly patients with coronary heart disease undergoing elective PCI.
目的
本研究旨在探讨无症状高尿酸血症对老年冠状动脉疾病（CAD）患者择期经皮冠状动脉介入治疗（PCI）后死亡率的影响。
方法
纳入2015年1月至2016年1月期间1296例年龄≥65岁、有尿酸升高记录且无痛风病史的冠心病患者进行择期PCI。高尿酸血症定义为男性血清尿酸水平>420μmol/l（7mg/dl），女性>357μmol/l（6mg/dl）。患者分为高尿酸血症组和非高尿酸血症组。平均随访519天后，比较两组的死亡率差异。
结果
高尿酸血症组236例，非高尿酸血症组1060例。高尿酸血症组BMI较高（P = 0.036）；高血压患者比例（P < 0.001）和有心肌梗死病史患者比例（P = 0.046）较高；白细胞（P = 0.015）和甘油三酯水平较高（P < 0.001）；估算肾小球滤过率（P < 0.001）和高密度脂蛋白胆固醇水平较低（P = 0.007）。此外，高尿酸血症组住院期间使用利尿剂治疗的患者比例（P < 0.001）和PCI病变数量较多（P = 0.030），完全血运重建率较低（P = 0.017）。高尿酸血症组死亡率（2.2%对7.6%，P < 0.001）显著高于非高尿酸血症组。多因素Cox回归分析显示，调整其他因素后，高尿酸血症是PCI后死亡率增加的独立危险因素（HR 2.786，95%CI 1.233 - 6.297，P = 0.014）。
结论
无症状高尿酸血症是老年冠心病患者择期PCI后死亡率增加的独立危险因素。
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