Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
Nutr Metab Cardiovasc Dis. 2023 Jan;33(1):133-140. doi: 10.1016/j.numecd.2022.09.011. Epub 2022 Sep 26.
Hyperuricemia is a known risk factor for cardiovascular diseases, but little is known on whether the association between hyperuricemia and poor outcomes in ST-segment elevation myocardial infarction (STEMI) is modified by low-density lipoprotein cholesterol (LDL-c). This study aimed to investigate the effect of the interaction between hyperuricemia and LDL-c on the risk of 1-year post-discharge all-cause mortality in STEMI patients.
A total of 1396 STEMI patients were included. Cox proportional hazards models were used to determine the association between hyperuricemia and 1-year all-cause mortality in the overall population and subgroups stratified based on LDL-c levels (<3.0 mmol/L or ≥3.0 mmol/L). Multivariate analysis indicated that hyperuricemia was associated with 1-year mortality (HR: 2.66; 95% CI: 1.30-5.47; p = 0.008). However, the prognostic effect of hyperuricemia was only observed in patients with LDL-c level ≥3.0 mmol/L (HR: 12.90; 95% CI: 2.98-55.77; p < 0.001), but not in those with LDL-c level <3.0 mmol/L (HR: 0.91, 95% CI: 0.30-2.79, p = 0.875). The interaction between hyperuricemia and LDL-c levels had a significant effect on 1-year mortality.
Hyperuricemia was associated with increased 1-year post-discharge mortality in patients with LDL-c level≥ 3.0 mmol/L, but not in those with LDL-c level< 3.0 mmol/L.
高尿酸血症是心血管疾病的已知危险因素,但对于高尿酸血症与 ST 段抬高型心肌梗死(STEMI)不良预后之间的关联是否受低密度脂蛋白胆固醇(LDL-c)的影响知之甚少。本研究旨在探讨高尿酸血症与 LDL-c 之间相互作用对 STEMI 患者出院后 1 年全因死亡率的影响。
共纳入 1396 例 STEMI 患者。Cox 比例风险模型用于确定总体人群中高尿酸血症与 1 年全因死亡率之间的关系,并根据 LDL-c 水平(<3.0mmol/L 或≥3.0mmol/L)进行分层。多变量分析表明,高尿酸血症与 1 年死亡率相关(HR:2.66;95%CI:1.30-5.47;p=0.008)。然而,高尿酸血症的预后作用仅在 LDL-c 水平≥3.0mmol/L 的患者中观察到(HR:12.90;95%CI:2.98-55.77;p<0.001),而在 LDL-c 水平<3.0mmol/L 的患者中则没有观察到(HR:0.91,95%CI:0.30-2.79,p=0.875)。高尿酸血症和 LDL-c 水平之间的相互作用对 1 年死亡率有显著影响。
在 LDL-c 水平≥3.0mmol/L 的患者中,高尿酸血症与出院后 1 年死亡率增加相关,但在 LDL-c 水平<3.0mmol/L 的患者中则无此关联。