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高尿酸血症与 ST 段抬高型心肌梗死患者经皮冠状动脉介入治疗后室性心动过速和颤动的发生率增加相关。

Hyperuricemia is associated with an increased prevalence of ventricular tachycardia and fibrillation in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention.

机构信息

Department of Cardiovascular Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, No. 365, East Renmin Road, Jinhua, 321000, Zhejiang Province, China.

Department of Respiratory Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua, Zhejiang Province, China.

出版信息

BMC Cardiovasc Disord. 2022 Apr 26;22(1):199. doi: 10.1186/s12872-022-02635-4.

Abstract

BACKGROUND

Little is known about the association between hyperuricemia and ventricular tachycardia and fibrillation (VT/VF) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).

METHODS

The data from a cohort of STEMI patients undergoing PPCI at our center from January 2013 to December 2018 were retrospectively analyzed. The endpoint of the study was the occurrence of VT/VF, including (1) non-sustained ventricular tachycardia (nsVT) on Holter monitoring; (2) sustained ventricular tachycardia (SVT)/VF on cardiac monitoring.

RESULTS

Of the 634 patients included in the study, 147 (23.2%) of them had hyperuricemia. The occurrence of VT/VF after PPCI was significantly higher in patients with hyperuricemia (19.0 vs. 9.4%, p = 0.001) compared with those without hyperuricemia. Hyperuricemia was associated with a significantly higher risk of VF/VT (odds ratio (OR) 2.11; 95% CI 1.11-4.03; p = 0.024). The strength of this association remained statistically after adjustments for age, sex, history of hypertension, estimated glomerular filtration rate, hypersensitive C reactive protein, plasma natrium, peak troponin I, fasting glucose, B-type natriuretic peptides and VT/VF in PPCI (adjusted odds ratio 2.73; 95% CI 1.19-6.27; p = 0.018).

CONCLUSIONS

There is a significant association between hyperuricemia and increased prevalence of VT/VF in STEMI patients after PPCI, independently of multiple risk factors and potential confounders.

摘要

背景

在接受直接经皮冠状动脉介入治疗(PPCI)的 ST 段抬高型心肌梗死(STEMI)患者中,高尿酸血症与室性心动过速和颤动(VT/VF)之间的关联知之甚少。

方法

回顾性分析了 2013 年 1 月至 2018 年 12 月期间在我院接受 PPCI 的 STEMI 患者的队列数据。该研究的终点是 VT/VF 的发生,包括(1)Holter 监测时的非持续性室性心动过速(nsVT);(2)心脏监测时的持续性室性心动过速(SVT)/VF。

结果

在纳入研究的 634 例患者中,147 例(23.2%)存在高尿酸血症。与无高尿酸血症患者相比,PPCI 后 VT/VF 的发生率在高尿酸血症患者中明显更高(19.0% vs. 9.4%,p=0.001)。高尿酸血症与 VF/VT 的发生风险显著相关(优势比(OR)2.11;95%可信区间 1.11-4.03;p=0.024)。在调整年龄、性别、高血压史、估算肾小球滤过率、超敏 C 反应蛋白、血浆钠、肌钙蛋白 I 峰值、空腹血糖、B 型利钠肽和 PPCI 中的 VT/VF 后,这种相关性仍然具有统计学意义(调整后的 OR 2.73;95%可信区间 1.19-6.27;p=0.018)。

结论

在接受 PPCI 的 STEMI 患者中,高尿酸血症与 VT/VF 的发生率增加显著相关,独立于多种危险因素和潜在的混杂因素。

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本文引用的文献

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Elevated uric acid is related to the no-/slow-reflow phenomenon in STEMI undergoing primary PCI.
Eur J Clin Invest. 2022 Apr;52(4):e13719. doi: 10.1111/eci.13719. Epub 2021 Nov 26.
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