School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510006, China.
Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China.
BMC Cardiovasc Disord. 2024 Jan 16;24(1):52. doi: 10.1186/s12872-024-03720-6.
The role of Serum uric acid (SUA) in acute myocardial infarction (AMI) was controversial, which might be influenced by the renal clearance function of the patients. The present study aimed to explore the association between serum uric acid to serum creatinine ratio (SUA/Scr), reflecting a net production of SUA, and the in-hospital outcomes of elderly patients with AMI.
In this retrospective study, a total of 330 elderly AMI patients (≥ 75 years) were enrolled. Data of SUA and Scr on admission were collected to calculate SUA/Scr ratio. Logistic regression analysis and receiver-operating curves were performed to assess the association between SUA/Scr ratio and in-hospital major adverse cardiovascular events (MACEs) and all-cause death.
Among the 330 patients, 68 patients had MACEs and 44 patients died. Patients with MACEs or died had lower SUA/Scr values compared with those without MACEs or survival (P < 0.05). Univariate logistic analysis showed that a lower value of SUA/Scr (< 3.45) was significantly associated with in-hospital MACEs (odd ratios (OR): 2.359, 95% confidential interval (CI): 1.369-4.065, P = 0.002) and death (OR: 2.424, 95% CI: 1.275-4.608, P = 0.007). After correcting for confounding factors, a lower SUA/Scr value was still independently associated with in-hospital MACEs (OR: 2.144, 95% CI: 1.169-3.934, P = 0.014) and death (OR: 2.125, 95% CI: 1.050-4.302, P = 0.036). Subgroup analysis showed that the association between a lower SUA/Scr ratio and increased risk of in-hospital outcomes could observed only in males (OR: 2.511, 95%CI: 1.211-5.207, P = 0.013 for MACEs; OR: 2.730, 95% CI: 1.146-6.502, P = 0.023 for death).
A lower SUA/Scr ratio was associated with an increased risk of in-hospital adverse events in elderly patients with AMI, especially in males, which maybe a marker of poor outcomes for elderly AMI patients.
血清尿酸（SUA）在急性心肌梗死（AMI）中的作用存在争议，这可能受患者肾脏清除功能的影响。本研究旨在探讨血清尿酸与血清肌酐比值（SUA/Scr）与老年 AMI 患者住院期间结局的关系，该比值反映了 SUA 的净生成。
本回顾性研究共纳入 330 例老年 AMI 患者（≥75 岁）。入院时收集 SUA 和 Scr 数据，计算 SUA/Scr 比值。采用 logistic 回归分析和受试者工作特征曲线评估 SUA/Scr 比值与住院期间主要不良心血管事件（MACEs）和全因死亡的关系。
在 330 例患者中，68 例发生 MACEs，44 例死亡。发生 MACEs 或死亡的患者的 SUA/Scr 值低于无 MACEs 或存活的患者（P<0.05）。单因素 logistic 分析显示，SUA/Scr 值较低（<3.45）与住院期间 MACEs（比值比（OR）：2.359，95%置信区间（CI）：1.369-4.065，P=0.002）和死亡（OR：2.424，95%CI：1.275-4.608，P=0.007）显著相关。校正混杂因素后，较低的 SUA/Scr 值仍与住院期间 MACEs（OR：2.144，95%CI：1.169-3.934，P=0.014）和死亡（OR：2.125，95%CI：1.050-4.302，P=0.036）独立相关。亚组分析显示，SUA/Scr 比值较低与住院期间结局风险增加之间的关联仅在男性中观察到（MACEs 的 OR：2.511，95%CI：1.211-5.207，P=0.013；死亡的 OR：2.730，95%CI：1.146-6.502，P=0.023）。
SUA/Scr 比值较低与老年 AMI 患者住院期间不良事件风险增加相关，尤其是在男性中，这可能是老年 AMI 患者预后不良的标志物。
