Department of Cardiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
Hellenic J Cardiol. 2022 May-Jun;65:35-41. doi: 10.1016/j.hjc.2022.03.009. Epub 2022 Apr 2.
Hyperuricemia is associated with poor outcomes in chronic heart failure (HF). We aimed to evaluate whether uric acid (UA) alone or in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a good predictor of all-cause mortality, HF hospitalization, and the composite endpoint of HF hospitalization or all-cause mortality in chronic HF.
UA and NT-proBNP levels were evaluated retrospectively in 861 chronic HF patients with a left ventricular ejection fraction of ≤50%. The patients were compared by dividing them into 4 groups according to the cut-off values of UA and NT-proBNP.
Serum UA concentrations were ≥ 7.0 mg/dL in 46.5% of the subjects. With a median follow-up of 30 months, 201 (23.3%) patients died and 308 (35.8%) patients were hospitalized during the study. The all-cause mortality rate was higher in the hyperuricemic group than that of the normouricemic group (p < 0.001). A multivariate Cox regression model revealed that UA and NT-proBNP were independent predictors of all-cause mortality (HR: 1.105, 95% CI: 1.019-1.198, p = 0.016 and HR: 3.743, CI: 2.647-5.292, p < 0.001, respectively). Patients were divided into 4 groups based on UA (≥ 7 and < 7 mg/dL) and NT-proBNP (≥ 2279 and < 2279 ng/L) levels. All-cause mortality, HF hospitalization, and the composite endpoint of HF hospitalization or all-cause mortality rates were higher in the group with high UA and NT-proBNP levels (p < 0.001, p < 0.001, p < 0.001, respectively).
Hyperuricemia alone is an independent predictor of all-cause mortality in chronic HF. However, the combination of UA and NT-proBNP appears to be a stronger predictor of poor outcomes.
高尿酸血症与慢性心力衰竭（HF）不良预后相关。本研究旨在评估尿酸（UA）单独或与氨基末端脑利钠肽前体（NT-proBNP）联合能否作为预测慢性 HF 全因死亡率、HF 住院率以及 HF 住院或全因死亡率复合终点的良好指标。
回顾性分析了 861 例左心室射血分数≤50%的慢性 HF 患者的 UA 和 NT-proBNP 水平。根据 UA 和 NT-proBNP 的截断值，将患者分为 4 组进行比较。
46.5%的患者 UA 浓度≥7.0mg/dL。中位随访 30 个月期间，201 例（23.3%）患者死亡，308 例（35.8%）患者住院。高尿酸血症组的全因死亡率高于正常尿酸血症组（p<0.001）。多变量 Cox 回归模型显示，UA 和 NT-proBNP 是全因死亡率的独立预测因素（HR：1.105，95%CI：1.019-1.198，p=0.016 和 HR：3.743，CI：2.647-5.292，p<0.001）。根据 UA（≥7 和<7mg/dL）和 NT-proBNP（≥2279 和<2279ng/L）水平将患者分为 4 组。UA 和 NT-proBNP 水平较高组的全因死亡率、HF 住院率和 HF 住院或全因死亡率复合终点较高（p<0.001，p<0.001，p<0.001）。
高尿酸血症单独是慢性 HF 全因死亡率的独立预测因素。然而，UA 和 NT-proBNP 联合似乎是不良预后的更强预测指标。
