Ayoub Mohamed, Mashayekhi Kambis, Behnes Michael, Schupp Tobias, Akin Muharrem, Forner Jan, Akin Ibrahim, Neumann Franz-Josef, Westermann Dirk, Rudolph Volker, Toma Aurel
Division of Cardiology and Angiology, Heart Center University of Bochum, 32545 Bad Oeynhausen, Germany.
Department of Internal Medicine and Cardiology, Mediclin Heart Centre Lahr, 77933 Lahr, Germany.
J Clin Med. 2023 May 31;12(11):3794. doi: 10.3390/jcm12113794.
Recent data suggest that uric acid (UA) might be an independent predictor of clinical outcomes following percutaneous coronary intervention (PCI). The predictive value of uric acid in patients undergoing PCI for chronic total occlusions (CTO) is unknown. We included patients with CTO who underwent PCI at our center in 2005 and 2012, with available uric acid levels before angiography. Subjects were divided into groups according to uric acid tertiles (<5.5 mg/dL, 5.6-6.9 mg/dL, and >7.0 mg/dL), and outcomes were compared among the groups. Out of the 1963 patients (mean age 65.2 ± 11 years), 34.7% ( = 682) had uric acid concentrations in the first tertile, 34.3% ( = 673) in the second tertile, and 31% ( = 608) in the third tertile. Median follow-up was 3.0 years. Uric acid levels in the first tertile were associated with significantly lower all-cause mortality, as compared to the third tertile, with an adjusted hazard ratio (HR) of 0.67 (95% confidence interval (CI): 0.49 to 0.92; = 0.012). No significant differences regarding all-cause mortality were found between patients in the first and second tertiles (HR: 0.96 [95% CI: 0.71 to 1.3; = 0.78]). High levels of uric acid emerged as an independent predictor of all-cause mortality in patients with chronic total occlusion treated with PCI. Hence, uric acid levels should be incorporated into the risk assessment of patients with CTO.
近期数据表明，尿酸（UA）可能是经皮冠状动脉介入治疗（PCI）后临床结局的独立预测指标。尿酸在接受PCI治疗慢性完全闭塞病变（CTO）患者中的预测价值尚不清楚。我们纳入了2005年至2012年在本中心接受PCI治疗的CTO患者，这些患者在血管造影前有可用的尿酸水平。根据尿酸三分位数（<5.5mg/dL、5.6 - 6.9mg/dL和>7.0mg/dL）将受试者分组，并比较各组的结局。在1963例患者（平均年龄65.2±11岁）中，34.7%（n = 682）的尿酸浓度处于第一三分位数，34.3%（n = 673）处于第二三分位数，31%（n = 608）处于第三三分位数。中位随访时间为3.0年。与第三三分位数相比，第一三分位数的尿酸水平与显著更低的全因死亡率相关，调整后的风险比（HR）为0.67（95%置信区间（CI）：0.49至0.92；P = 0.012）。第一和第二三分位数的患者之间在全因死亡率方面未发现显著差异（HR：0.96 [95% CI：0.71至1.3；P = 0.78]）。高尿酸水平成为接受PCI治疗的慢性完全闭塞病变患者全因死亡率的独立预测指标。因此，尿酸水平应纳入CTO患者的风险评估中。
