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Wang R, Wu S, Wang J, Li W, Cui J, Yao Z. A nonlinear correlation between the serum uric acid to creatinine ratio and the prevalence of hypertension: a large cross-sectional population-based study. Ren Fail 2024; 46:2296002. [PMID: 38186345 PMCID: PMC10776046 DOI: 10.1080/0886022x.2023.2296002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVE To explore the relationship between the serum uric acid to creatinine (UA/Cr) ratio and the prevalence of hypertension. METHODS In this cross-sectional study, we included 8571 individuals from the China Health and Nutrition Survey. Logistic regression analysis and restricted cubic spline (RCS) were used to analyze the relationship between the UA/Cr ratio and hypertension. RESULTS Compared with individuals without hypertension, individuals with hypertension had higher UA/Cr ratios. Multivariate logistic regression analysis showed that a higher UA/Cr ratio was closely related to a higher risk of hypertension (as a continuous variable, OR: 1.054, 95% CI: 1.014-1.095, p = 0.007; as a categorical variable, Q3 vs. Q1, OR: 1.183, 95% CI: 1.011-1.384, p = 0.035; Q4 vs. Q1, OR: 1.347, 95% CI: 1.146-1.582, p < 0.001). Subgroup analysis revealed that the correlation between the UA/Cr ratio and hypertension risk was stable in all subgroups except for the subgroup with diabetes and the subgroup with a BMI ≥ 28 kg/m2 (p < 0.05). Sensitivity analysis confirmed the robustness of the relationship between a higher UA/Cr ratio and a higher risk of hypertension (p < 0.05). The RCS showed that the UA/Cr ratio was nonlinearly related to hypertension risk. Further threshold effect showed that only a UA/Cr ratio less than 5.0 was related to hypertension risk (OR: 1.178, 95% CI: 1.086-1.278, p < 0.001), and the 2-piecewise linear regression model was superior to the 1-line linear regression model (p < 0.05). CONCLUSION The UA/Cr ratio was associated with the prevalence of hypertension.
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Affiliation(s)
- Ru Wang
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
| | - Shuxing Wu
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Jing Wang
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Wenting Li
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Jian Cui
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Zhuhua Yao
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
- The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
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Wu X, Xu Z, Yang X, Li J, Feng Y. Left atrial size modify the association between uric acid and atrial fibrillation in patients with coronary artery disease. Nutr Metab Cardiovasc Dis 2024; 34:1559-1570. [PMID: 38658225 DOI: 10.1016/j.numecd.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/23/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIMS The potential influence of left atrial size on the relationship between uric acid and atrial fibrillation has not been fully investigated. This study aims to evaluate the interaction effect of left atrial size on the association between uric acid and atrial fibrillation in patients with coronary artery disease. METHODS AND RESULTS This retrospective cohort study, conducted from January 2018 to October 2022, included 2004 patients undergoing Drug-Eluting Stent implantation for coronary artery disease. Utilizing logistic regression models with the product of left atrial enlargement (LAE) and uric acid, interaction effects were assessed. Among the participants, 383 had LAE, and 159 experienced atrial fibrillation. After adjusting for covariates, continuous uric acid levels were associated with an increased risk of atrial fibrillation in patients without LAE (OR:1.631, 95% CI: 1.284-2.072), but not in those with LAE (OR:1.069, 95% CI: 0.848-1.348). A significant interaction of uric acid levels was observed between groups with and without LAE (p = 0.046). Restricted cubic spline curves indicated a J-shaped relationship between uric acid and atrial fibrillation in the absence of LAE. However, the association between uric acid levels and atrial fibrillation in the LAE group remained unchanged with increasing uric acid levels. CONCLUSION The study suggested that left atrial size modified the association between uric acid and atrial fibrillation in patients with coronary artery disease. Uric acid serves as a potential biomarker for atrial fibrillation risk, especially in individuals without LAE.
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Affiliation(s)
- Xuefeng Wu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Cardiology, The First People's Hospital of Foshan, Foshan, China; Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zhaoyan Xu
- Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
| | - Xili Yang
- Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
| | - Jianming Li
- Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
| | - Yingqing Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
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Li F, Lin Q, Zhou J, Zhu J, Zhou Y, Wu K, Li Q, Zhao D, Liu Q. A high level of uric acid is associated with long-term adverse cardiovascular outcomes in patients who received fractional flow reserve with coronary intermediate stenosis. Nutr Metab Cardiovasc Dis 2024; 34:1538-1545. [PMID: 38644080 DOI: 10.1016/j.numecd.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/19/2024] [Accepted: 03/01/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND AIMS The role of fractional flow reserve (FFR) in coronary intermediate lesions is widely recommended by guidelines. The effect of uric acid (UA) on cardiovascular events is also well known. However, the relationship between UA and long-term cardiovascular outcomes in patients who received FFR with intermediate lesions remains unknown. METHODS AND RESULTS We retrospectively included 428 patients who underwent both coronary angiography (CAG) and FFR. Participants were stratified into two groups based on the median UA. The primary endpoint was the composite of major adverse cardiovascular and cerebrovascular events (MACCEs), including repeat revascularization, nonfatal stroke, nonfatal myocardial infarction, and all-cause death. A Cox proportional hazards model was utilized to analyze the association between UA and the prevalence of MACCEs. During a median follow-up of 5.8 years, a higher MACCEs rate occurred in the high UA group compared to the low UA group (16.8% vs. 5.1%, p log-rank<0.01). Elevated UA was independently linked to a higher incidence of MACCEs, whether UA was treated as a categorical or continuous variable (hazard ratio [HR] 2.76, 95% confidence interval [CI] 1.27-6.03 or HR 1.01, 95% CI 1.01-1.02). The restricted cubic spline (RCS) analysis illustrated that the HR for MACCEs increased with increasing UA. CONCLUSION The present study demonstrates that UA is associated with MACCEs risk and suggests that UA is a reliable predictor of long-term cardiovascular events in coronary intermediate stenosis patients.
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Affiliation(s)
- Fanqi Li
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Qiuzhen Lin
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Jiabao Zhou
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Jiayi Zhu
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Yong Zhou
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Keke Wu
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Qiuyu Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Disease, Beijing 100029, China
| | - Donghui Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Disease, Beijing 100029, China.
| | - Qiming Liu
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China.
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Du P, Gao X, Sun Q, Gong M, Pan Y, Guo Q, Zhao X, Guo R, Liu Y. Association between uric acid and cardiac outcomes mediated by neutrophil-to-lymphocyte ratio in patients with left ventricular diastolic dysfunction and pulmonary hypertension. Sci Rep 2024; 14:2751. [PMID: 38302600 PMCID: PMC10834525 DOI: 10.1038/s41598-024-53077-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/27/2024] [Indexed: 02/03/2024] Open
Abstract
To evaluate the association of uric acid (UA) with adverse outcomes and its potential mediator in patients with left ventricular diastolic dysfunction (LVDD) and pulmonary hypertension (PH). We retrospectively analyzed 234 patients with LVDD and PH. The baseline characteristics of patients with low UA (≤ 330 µmol/L) group were compared with high UA (> 330 µmol/L) group. Adverse outcomes included all-cause mortality, cardiac death and heart failure (HF) hospitalization. Their association with UA and the mediator were evaluated using Cox regression and mediation analysis. The mediation proportion was further quantified by the R mediation package. During a mean follow-up of 50 ± 18 months, there were 27 all-cause deaths, 18 cardiovascular deaths and 41 incidents of HF hospitalization. Multivariable Cox regression analysis showed UA was an independent risk factor of adverse outcomes in LVDD and PH patients, even after adjusting for age, sex, body mass index, medical histories, systolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, eGFR, BNP and medications. The hazard ratios (HRs) for UA (per 10 µmol/L increase) were as below: for all-cause mortality, HR 1.143, 95% CI 1.069-1.221, P < 0.001; for cardiac death, HR 1.168, 95% CI 1.064-1.282, P = 0.001; for HF hospitalization, HR 1.093, 95% CI 1.035-1.155, P = 0.001. Neutrophil-to-lymphocyte ratio (NLR) played a partial mediation role in the association, and the mediation proportion for NLR on the UA-adverse outcomes were 21%, 19% and 17%, respectively. In patients of LVDD with PH, higher UA level was independently correlated with adverse outcomes. Furthermore, NLR partially mediated the effect of UA on the risk of all-cause mortality, cardiac death and HF hospitalization.
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Affiliation(s)
- Ping Du
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xin Gao
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qiaobing Sun
- Department of Cardiovascular Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Minghui Gong
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu Pan
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qinpeng Guo
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xu Zhao
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ran Guo
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Yan Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
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Yang B, Ma K, Xiang R, Yang G, Luo Y, Wu F, Mao M. Uric acid and evaluate the coronary vascular stenosis gensini score correlation research and in gender differences. BMC Cardiovasc Disord 2023; 23:546. [PMID: 37940848 PMCID: PMC10634079 DOI: 10.1186/s12872-023-03581-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND AND AIMS Recent studies have shown that the negative effect of uric acid (UA) on coronary arteries determines the severity of atherosclerotic disease. This study aims to explore the relationship between serum UA level and Gensini score, which reflects the severity of coronary artery disease. METHODS A total of 860 patients with suspected coronary heart disease who were admitted to hospital due to angina pectoris or myocardial ischemia related symptoms and received coronary angiography were selected. Based on the findings of the angiography, they were categorized into two groups: the coronary heart disease (CHD) group (n = 625) and the control group (n = 235). The uric acid levels and other clinical data were compared between these groups. Additionally, the prevalence of coronary heart disease and Gensini score were compared between the groups, considering gender-specific quartiles of uric acid levels. The clinical baseline data were analyzed using appropriate statistical methods, and multivariate logistic regression analysis was conducted to identify independent risk factors for coronary heart disease. RESULTS Of 860 patients (mean age, 63.97 ± 11.87 years), 528 were men (mean age, 62.06 ± 11.5 years) and 332 were women (mean age, 66.99 ± 10.11 years). The proportion of smoking, diabetes, hypertension, and hyperlipidemia in the coronary heart disease group was higher than that in the control group (P < 0.05). HbA1C, Gensini score, BMI, TG and hsCRP in the coronary heart disease group were higher than those in the control group (P < 0.05), and HDL-C was lower than that in the control group (P < 0.05). There were no significant differences in age, heart rate, Cr, TC and LDL-C between the two groups (P > 0.05).Multivariate logistic regression analysis showed that age, hypertension, hsCRP and SUA levels increased the risk of coronary heart disease, and the difference was statistically significant(OR = 1.034,95%CI 1.016-1.052, P = 0.001; OR = 1.469,95%CI 1.007-2.142, P = 0.046;OR = 1.064,95%CI 1.026-1.105, P = 0.001; OR = 1.011,95%CI 1.008-1.014, P < 0.001). CONCLUSION Serum uric acid is positively correlated with Gensini score in patients with coronary heart disease, which is an independent factor for evaluating the degree of coronary artery stenosis and has a predictive effect.
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Affiliation(s)
- Bao Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Kanghua Ma
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Rui Xiang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Guoli Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Yue Luo
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Fan Wu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Min Mao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China.
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Han F, Yu C, Hu F, Zhou W, Wang T, Zhu L, Huang X, Bao H, Cheng X. Association between serum uric acid levels and peripheral artery disease in Chinese adults with hypertension. Front Endocrinol (Lausanne) 2023; 14:1197628. [PMID: 37674616 PMCID: PMC10478083 DOI: 10.3389/fendo.2023.1197628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/31/2023] [Indexed: 09/08/2023] Open
Abstract
Background Higher serum uric acid (SUA) can cause gout, which is principally characterized by arthritis due to monosodium urate crystal deposition in the lower extremities. High levels of SUA have been linked to endothelial dysfunction, oxidative stress, and inflammation, all of which are involved in the pathogenesis of peripheral artery disease(PAD). To date, the relationship between SUA levels and PAD is still poorly understood. Method An analysis of 9,839 Chinese adults with essential hypertension from the ongoing China H-type Hypertension Registry Study was conducted in this cross-sectional study. Patients with an ABI ≤0.9 was diagnosed with PAD. Hyperuricemia was defined as SUA levels >420 mol/L in men and >360 mol/L in women. The association between SUA levels and PAD was evaluated using multivariable logistic regression models based on odds ratios (ORs) and their 95% confidence intervals (CIs). Results The enrolled subjects ranged in age from 27 to 93 years, with a mean age of 63.14 ± 8.99 years. The proportion of male patients was 46.22%, and the prevalence of hyperuricemia was 50.72%. In males, hyperuricemia was positively associated with the risk of PAD (adjusted OR per SD increase: 1.72, 95% CI 1.17 to 2.53, P =0.006). Males in the highest SUA tertile were significantly more likely to have PAD (adjusted OR: 2.63, 95% CI 1.42 to 4.86, P = 0.002; P for trend = 0.001). However, this positive relationship was not observed in females (adjusted OR: 1.29, 95% CI 0.77 to 2.17, P = 0.327; P for trend = 0.347). Conclusion According to this cross-sectional study, higher SUA levels were positively associated with PAD in male hypertensive patients, while this positive relationship disappeared in female participants.
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Affiliation(s)
- Fengyu Han
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Feng Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Linjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Yuan SL, Kim MH, Lee KM, Jin X, Song ZY, Park JS, Cho YR, Lim K, Yun SC. Sex differences between serum uric acid levels and cardiovascular outcomes in patients with coronary artery disease after stent implantation. Front Cardiovasc Med 2023; 10:1021277. [PMID: 36815018 PMCID: PMC9939523 DOI: 10.3389/fcvm.2023.1021277] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/16/2023] [Indexed: 02/09/2023] Open
Abstract
Background The relationship between elevated serum uric acid (SUA) levels and cardiovascular outcomes after stent implantation remains uncertain. This study sought to evaluate the impact of SUA on 12-month cardiovascular outcomes after stent implantation. Methods We performed a retrospective study of patients who successfully underwent stent implantation and enrolled 3,222 patients with coronary artery disease (CAD) from a single center. SUA levels were measured before stent implantation. The patients were divided into six groups (<4, 4-4.9, 5-5.9, 6-6.9, 7-7.9 and ≥ 8 mg/dL) at SUA intervals of 1.0 mg/dL. The incidence of cardiovascular outcomes in the six groups was monitored for 1 year after stent implantation and the hazard ratios were estimated. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for cardiovascular outcomes were estimated using a Cox proportional hazard regression analysis. The primary endpoint was all-cause death. The secondary endpoint was a composite of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis and stroke. The follow-up duration was 12 months. Results Over the 12-month follow-up period, there were 101 all-cause deaths and 218 MACCE. After adjustment for several parameters, the group with SUA levels of more than or equal to 8 mg/dL had significantly higher hazard ratios in the incidence of all-cause death or MACCE. The group with <4.0 mg/dL had significantly higher hazard ratios in all-cause death only in male patients. In contrast, there were no significant differences observed for cardiovascular outcomes in female patients. Conclusions Our study identified a U-shaped association between SUA levels and cardiovascular outcomes during 12-month follow-up for males, but not for females. Further studies are warranted to clarify the sex differences between SUA levels and clinical outcomes.
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Affiliation(s)
- Song Lin Yuan
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Moo Hyun Kim
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea,*Correspondence: Moo Hyun Kim ✉
| | - Kwang Min Lee
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Xuan Jin
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Zhao Yan Song
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Jong-Sung Park
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Young-Rak Cho
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Kyunghee Lim
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Sun G, Liu Y, Rong D, Liang X. Association between serum uric acid levels and the prevalence of heart failure due to acute coronary syndrome in Chinese hospitalized patients: A cross-sectional study. Nutr Metab Cardiovasc Dis 2023; 33:308-314. [PMID: 36586774 DOI: 10.1016/j.numecd.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/11/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND AIMS Serum uric acid (SUA) may play a role in heart failure (HF). Our study was to find relationships between SUA and the prevalence of HF due to acute coronary syndrome (ACS), and the ethnic-specific relationship between them in an inpatient population. METHODS AND RESULTS We analyzed 1075 Chinese ACS patients. SUA levels were cut to four groups as Q1 to Q4, according to quartiles. Binary logistic regression models were used to assess associations of SUA with HF due to ACS. Subgroup analysis was performed to find ethnic-specific association between SUA and HF due to ACS. We also performed univariate and multivariate logistic regression analyses taking into account an Italian's cut-off for SUA for HF prognosis stratification. After adjustment for all potential confounders, compared to the lowest quartile, quartiles 2, 3 and 4 had a prevalence OR of 0.69 (0.44-1.08), 1.06 (0.67-1.67) and 2.19 (1.35-3.56), respectively, for the HF due to ACS (p for trend <0.001). Subgroup analyses didn't reveal an ethnic-specific differences between SUA and HF due to ACS. In Han, the highest SUA level was significantly associated with the risk of HF due to ACS. OR with 95%CI for Q4 was 1.85 (1.02-3.37), Q1 as a reference. For Mongolians, the OR with 95%CI for Q4 was 6.82 (1.90-24.50), Q1 as a reference. CONCLUSION We found positive associations between SUA and the prevalence of HF due to ACS among Chinese patients. No differences exist regarding ethnicity.
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Affiliation(s)
- Guotong Sun
- Suzhou Medical College of Soochow University, Soochow University, Suzhou, 215000, Jiangsu, China; Department of Cardiology, Hulunbuir People's Hospital, Hulunbuir, 021000, Inner Mongolia, China; Department of Cardiology, Shouguang Hospital of T.C.M, Weifang, 262700, Shandong, China
| | - Yu Liu
- Department of Cardiology, Hulunbuir People's Hospital, Hulunbuir, 021000, Inner Mongolia, China; Medical College, Inner Mongolia Minzu University, Tongliao, 028000, Inner Mongolia, China
| | - Di Rong
- Suzhou Medical College of Soochow University, Soochow University, Suzhou, 215000, Jiangsu, China; Department of Geriatric, Hulunbuir People's Hospital, Hulunbuir, 021000, Inner Mongolia, China
| | - Xiuwen Liang
- Suzhou Medical College of Soochow University, Soochow University, Suzhou, 215000, Jiangsu, China; Medical College, Inner Mongolia Minzu University, Tongliao, 028000, Inner Mongolia, China; Department of Cardiology, Hulunbeir China Mongolia Hospital, Hulunbuir, 021000, Inner Mongolia, China.
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Yang Y, Lin C, Zheng Q, Zhang L, Li Y, Huang Q, Wu T, Zhao Z, Li L, Luo J, Jiang Y, Zhang Q, Wang X, Xia C, Pang J. L-carnitine attenuated hyperuricemia-associated left ventricular remodeling through ameliorating cardiomyocytic lipid deposition. Front Pharmacol 2023; 14:1016633. [PMID: 36817129 PMCID: PMC9929955 DOI: 10.3389/fphar.2023.1016633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Hyperuricemia (HUA) is associated with left ventricular remodeling (LVR) and thereby causes the initiation and development of a large number of cardiovascular diseases. LVR is typically accompanied by cardiomyocyte energy metabolic disorder. The energy supply of cardiomyocytes is provided by glucose and fatty acid (FA) metabolism. Currently, the effect of HUA on cardiomyocytic FA metabolism is unclear. In this study, we demonstrate that UA-induced cardiomyocyte injury is associated with cytoplasmic lipid deposition, which can be ameliorated by the FA metabolism-promoting drug L-carnitine (LC). UA suppresses carnitine palmitoyl transferase 1B (CPT1B), thereby inhibiting FA transport into the mitochondrial inner matrix for elimination. LC intervention can ameliorate HUA-associated left ventricular anterior wall thickening in mice. This study showed that FA transport dysfunction plays is a critical mechanism in both cardiomyocytic injury and HUA-associated LVR and promoting cytoplasmic FA transportation through pharmacological treatment by LC is a valid strategy to attenuate HUA-associated LVR.
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Affiliation(s)
- Yang Yang
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China,School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China,NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Cuiting Lin
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiang Zheng
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Leqi Zhang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Yongmei Li
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Qinghua Huang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Ting Wu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Zean Zhao
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Lu Li
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Jian Luo
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanqing Jiang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Qun Zhang
- Good Clinical Practice Development, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Xing Wang
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China,School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Chenglai Xia
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China,School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China,*Correspondence: Jianxin Pang, ; Chenglai Xia,
| | - Jianxin Pang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China,*Correspondence: Jianxin Pang, ; Chenglai Xia,
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10
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Lin C, Zheng Q, Li Y, Wu T, Luo J, Jiang Y, Huang Q, Yan C, Zhang L, Zhang W, Liao H, Yang Y, Pang J. Assessment of the influence on left ventricle by potassium oxonate and hypoxanthine-induced chronic hyperuricemia. Exp Biol Med (Maywood) 2023; 248:165-174. [PMID: 36112877 PMCID: PMC10041052 DOI: 10.1177/15353702221120113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cellular cytoplasmic xanthine oxidase (XO)-mediated uric acid synthesis and extracellular excess uric acid exposure are both causes of cardiomyocytic injury under the condition of hyperuricemia (HUA). Potassium oxonate suppresses uric acid degradation to increase extracellular concentration, while hypoxanthine is the catalytic substrate of XO. We aimed to observe cardiac damage in a chronic HUA mouse model induced by potassium oxonate and hypoxanthine. The mouse model was established by the co-administration of potassium oxonate and hypoxanthine for eight weeks. Then, left ventricular parameters were examined by echocardiographic evaluation, and the heart tissues were harvested for further histopathological analysis. The results showed that plasma uric acid was persistently elevated in the model mice, which demonstrated the stable establishment of chronic HUA. The left ventricular anterior wall was significantly thickened in the model group compared with the blank control group. After the end of modeling, the left ventricular anterior wall thickness of the hyperuricemic mice increased compared with that of blank group. The histological analysis showed and myocardial structure disorganization in the model group compared with the blank control. The above cardiac impairment changes could be attenuated by allopurinol pretreatment. This study systematically assessed cardiac damage in a chronic HUA mouse model. In addition, it provides useful information for future HUA-associated heart injury mechanism investigation and therapeutic treatment evaluation.
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Affiliation(s)
- Cuiting Lin
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Qiang Zheng
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yongmei Li
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Ting Wu
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Jian Luo
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yanqing Jiang
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Qinghua Huang
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Caixin Yan
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Leqi Zhang
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Wei Zhang
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Hui Liao
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Yang Yang
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan 528000, Guangdong, China
| | - Jianxin Pang
- Guangdong Provincial Key Laboratory of Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China
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11
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Li S, Chen H, Zhou L, Cui H, Liang S, Li H. The uric acid to albumin ratio: a novel predictor of long-term cardiac mortality in patients with unstable angina pectoris after percutaneous coronary intervention. Scandinavian Journal of Clinical and Laboratory Investigation 2022; 82:304-310. [PMID: 35675042 DOI: 10.1080/00365513.2022.2084698] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The prognosis of unstable angina pectoris (UAP) differs from non-ST-segment elevation myocardial infarction, and percutaneous coronary intervention (PCI) is considered to improve outcomes of UAP. This study aimed to assess the prognostic value of uric acid to albumin ratio (UAR) for long-term mortality in UAP patients after PCI. Our study retrospectively enrolled 2298 patients hospitalized because of UAP in a tertiary hospital. Divided by medium UAR, the patients were classified into two groups. Baseline demographics, clinical features and laboratory characteristics were obtained from medical records. Post-discharge follow-up was performed either in outdoor clinic or through phone call. The primary endpoint in this study was cardiac death, while all-cause death and rehospitalization were designated as the secondary endpoints. The median follow-up time was 672 days. Among all patients, 58 (2.5%) died, 28 of which died of cardiac deaths (1.2%), and 467 were re-hospitalized (20.3%). Cardiac mortality and all-cause mortality were found to be significantly higher in the high UAR group than in the low UAR group (p = 0.007, p < 0.001), and Kaplan-Meier analysis showed patients with higher UAR may suffer from worse outcomes (p = 0.020). UAR, PCI history, and age were identified as independent predictors of cardiac mortality by multivariate Cox regression. A UAR value of >8.35 was demonstrated as an ideal cut-off point to predict post-PCI cardiac mortality (p <0.001). Overall, it is indicated that baseline UAR was independently correlated with long-term cardiac mortality in patients with UAP treated by PCI.
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Affiliation(s)
- Shunbao Li
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.,Department of Cardiology, Baoding First Central Hospital, Baoding, China
| | - Hui Chen
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Li Zhou
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Hehe Cui
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Siwen Liang
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Hongwei Li
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
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12
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Zhang S, Liu X, Song B, Yu H, Zhang X, Shao Y. Impact of serum uric acid levels on the clinical prognosis and severity of coronary artery disease in patients with acute coronary syndrome and hypertension after percutaneous coronary intervention: a prospective cohort study. BMJ Open 2022; 12:e052031. [PMID: 35022171 PMCID: PMC8756275 DOI: 10.1136/bmjopen-2021-052031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The impact of serum uric acid (sUA) levels on the clinical prognosis and severity of coronary artery disease in patients with acute coronary syndrome (ACS) and hypertension after percutaneous coronary intervention (PCI) is not fully clear. This study aimed to assess the association among sUA levels, clinical prognosis and severity of coronary artery disease in patients with ACS and hypertension after PCI. DESIGN In this prospective cohort study, we followed-up patients with ACS and hypertension after PCI for 1 year to explore the risk factors for 1 year total major adverse cardiovascular events (MACEs) and multivessel coronary artery disease, the dose-effect relationship among sUA levels, MACEs and severity of coronary artery disease and correlation between sUA levels and severity of coronary artery disease (Gensini score). SETTING/PATIENTS Several Chinese internists followed-up 422 patients who were diagnosed with ACS and hypertension after PCI in a large tertiary hospital of Qingdao during the period from 1 June 2019 to 1 December 2019. OUTCOME MEASURES One-year follow-up MACEs results and coronary angiography results. RESULTS In the coronary angiography results, multivessel coronary artery disease (28.5% vs 21.4%, p=0.006) and non-culprit lesion vascular occlusion (11.7% vs 5.3%, p=0.042) were more common in the hyperuricaemia group, and the Gensini score (26.69±13.46 vs 17.66±10.57, p<0.001) was also higher. In the results of 1-year MACEs, the incidence of all-cause mortality (3.5% vs 2.5%, p=0.037), PCI or coronary artery bypass grafting therapy due to myocardial infarction or angina pectoris (15.1% vs 7.6%, p=0.027), medication conservative therapy in hospital due to myocardial infarction or angina pectoris (12.9% vs 6.7%, p=0.041) and total MACEs (31.8% vs 16.9%, p=0.001) were higher in patients with hyperuricaemia. Univariate and multivariate logistic regression analysis models showed that hyperuricaemia was still an independent risk factor for total MACEs within 1 year (OR=2.618, 95% CI 1.656 to 4.139, p<0.001; OR=1.920, 95% CI 1.158 to 3.183, p=0.011, respectively) and multivessel coronary artery disease (OR=2.140, 95% CI 1.371 to 3.342, p=0.001; OR=1.688, 95% CI 1.051 to 2.710, p=0.030, respectively) after adjusting for confounding factors. The severity of coronary artery disease (non-culprit lesion vascular occlusion (4.7% vs 8.4% vs 9.6% vs 16.2%, p=0.041); multivessel coronary artery disease (17.9% vs 22.4% vs 29.8% vs 35.2%, p=0.022); Gensini score (16.96±10.35 vs 19.31±10.63 vs 26.12±11.48 vs 33.33±14.01, p<0.001)) and the incidence of total MACEs (13.2% vs 14.2% vs 34.6% vs 41%, p<0.001) increased significantly with the sUA levels increasing. Further, the Gensini score was positively correlated with uric acid levels (r=0.515, p<0.001). CONCLUSIONS Hyperuricaemia is an independent risk factor for 1-year total MACEs and multivessel coronary artery disease in patients with ACS and hypertension after PCI.
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Affiliation(s)
- Shiyu Zhang
- Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, shandong, China
| | - Xin Liu
- Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, shandong, China
| | - Bingxue Song
- Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, shandong, China
| | - Haichu Yu
- Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, shandong, China
- Cardiology, The Affiliated Cardiovascular Hospital of Qingdao University, qingdao, shandong, china
| | - Xiaodong Zhang
- Cardiology, Jiaozhou Branch of Shanghai East Hospital,Tongji University, qingdao, shandong, china
| | - Yanming Shao
- Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, shandong, China
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13
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Feitosa RS, Martins BP, Almeida LM, de Oliveira MB, de Araújo RMS, de Oliveira KA. Serum uric acid is independently associated with metabolic syndrome and systemic hypertension in women from northeast Brazil. Women Health 2021; 62:68-74. [PMID: 34965850 DOI: 10.1080/03630242.2021.2019170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hyperuricemia (HU) has been associated with cardiovascular risk and metabolic syndrome (MS) worldwide. However, inconsistencies about this relation are still reported, and it is not clear whether hyperuricemia is an independent risk factor for MS. The aim of this study was to determine hyperuricemia associations with systemic hypertension and MS in women from northeast Brazil. The study included 301 women. Hyperuricemia was considered for serum uric acid (SUA) ≥6 mg/dL. Insulin resistance (IR) was measured by TyG index (TyG ≥ 4.55). Fisher test and Multivariate logistic regression analyses estimated the association between hyperuricemia (or SUA level) and systemic hypertension and MS. Hyperuricemia association with systemic hypertension was independent of age, body-mass index (BMI), smoking and alcoholism (OR: OR: 4.6050; p = .000256), and MS components (OR: 4.1296; IC95% 1.8330_9.3033; p = .000621). Hyperuricemia increased risk of systemic hypertension by 4,6 -fold. SUA level was associated with MS, independently of other classic component factors of the syndrome (OR:1.34, p = .0129). Hyperuricemia and high SUA levels were associated with MS and systemic hypertension. Effect of hyperuricemia in systemic hypertension is independent of age, BMI, lifestyle, and MS factors. SUA levels are independently associated with MS.
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Affiliation(s)
| | | | - Lucas Martins Almeida
- Medical School, Health Sciences Center, Federal University of Piauí, Teresina, Brazil
| | - Max Brandão de Oliveira
- Statistics Department, Nature Sciences Center, Federal University of Piauí, Teresina, Brazil
| | | | - Karla Andrade de Oliveira
- Biochemistry and Pharmacology Department, Health Sciences Center, Federal University of Piauí, Teresina, Brazil
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14
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Ma W, Gao S, Huang S, Yuan J, Yu M. Hyperuricemia as a prognostic marker for long-term outcomes in patients with myocardial infarction with nonobstructive coronary arteries. Nutr Metab (Lond) 2021; 18:107. [PMID: 34930343 PMCID: PMC8686602 DOI: 10.1186/s12986-021-00636-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/06/2021] [Indexed: 11/21/2022] Open
Abstract
Background Hyperuricemia (HUA) has been proved as a predictor of worse outcomes in patients with coronary artery disease. Here, we investigated the prognostic value of HUA in a distinct population with myocardial infarction with nonobstructive coronary arteries (MINOCA). Methods A total of 1179 MINOCA patients were enrolled and divided into HUA and non-HUA groups. HUA was defined as a serum uric acid level ≥ 420 μmol/L in men or ≥ 357 μmol/L in women. The primary study endpoint was a composite of major adverse cardiovascular events (MACE), including all-cause death, nonfatal MI, nonfatal stroke, revascularization, and hospitalization for unstable angina or heart failure. Kaplan–Meier, Cox regression, and receiver-operating characteristic analyses were performed. Results Patients with HUA (prevalence of 23.5%) had a significantly higher incidence of MACE (18.7% vs. 12.8%; p = 0.015) than patients without during the median follow-up of 41.7 months. HUA was closely associated with an increased risk of MACE even after multivariable adjustment (hazard ratio 1.498, 95% confidence interval: 1.080 to 2.077; p = 0.016). HUA remained a robust risk factor of MACE after propensity score matching analysis. Moreover, HUA showed an area under the curve (AUC) of 0.59 for predicting MACE. Incorporation of HUA to the thrombolysis in myocardial infarction (TIMI) score yielded a significant improvement in discrimination for MACE. Conclusions HUA was independently associated with poor prognosis after MINOCA. Routine assessment of HUA may facilitate risk stratification in this specific population. Supplementary Information The online version contains supplementary material available at 10.1186/s12986-021-00636-2.
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Affiliation(s)
- Wenjian Ma
- Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Side Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei Li Shi Rd 167, Beijing, 100037, PR China
| | - Sizhuang Huang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei Li Shi Rd 167, Beijing, 100037, PR China
| | - Jiansong Yuan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei Li Shi Rd 167, Beijing, 100037, PR China.
| | - Mengyue Yu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei Li Shi Rd 167, Beijing, 100037, PR China.
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15
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Xu S, Liu L, Yin G, Mohammed AQ, Lv X, Feng C, Shi T, Abdu FA, Che W. Prognostic Significance of Uric Acid in Patients with Obstructive and Nonobstructive Coronary Artery Disease Undergoing D-SPECT. Clin Interv Aging 2021; 16:1955-1965. [PMID: 34815667 PMCID: PMC8605808 DOI: 10.2147/cia.s339600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/06/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The association of serum uric acid (SUA) levels with cardiovascular outcomes in patients with coronary artery disease (CAD) has been extensively studied and yielded conflicting results. We aimed to investigate whether the severity of coronary stenosis and ischemia influences the prognostic impact of SUA levels in patients with CAD undergoing D-SPECT. Patients and Methods This study consecutively included patients who were admitted for CAD in Shanghai Tenth People's Hospital between June 2014 and August 2018, had complete SUA data and underwent both coronary angiography and D-SPECT within 3 months. Hyperuricemia was defined as an SUA level of >7 mg/dL in men and >6 mg/dL in women. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, unplanned coronary revascularization, nonfatal myocardial infarction, ischemic stroke, heart failure, and angina-related hospitalization. Results A total of 695 patients were included, of whom 432 (62.2%) presented with obstructive CAD and 117 (16.8%) had hyperuricemia. During a median follow-up of 26 months, the incidence rates of MACE in patients with hyperuricemia and normouricemia were 15.2% and 21.1%, respectively. After a multivariable adjustment, hyperuricemia was significantly associated with an increased risk of MACE (HR: 1.39, 95% CI: 1.03-1.87, p = 0.033) when compared with normouricemia. When repeating the primary analysis in patients with and without obstructive CAD, we showed that hyperuricemia was independently associated with an 80% increased risk of MACE among patients with nonobstructive CAD (HR: 1.80, 95% CI: 1.04-3.11, p = 0.035), while such a significant association was not found among those with obstructive CAD (HR: 1.18, 95% CI: 0.82-1.72, p = 0.373). Moreover, we uncovered a U-shaped and linear trajectory of SUA levels with MACE in the obstructive and nonobstructive CAD, respectively. The sex-specific analysis showed that the adverse impact of hyperuricemia was only pronounced in males (HR: 1.73, 95% CI: 1.18-2.53, p = 0.005) but not in females (HR: 0.98, 95% CI: 0.57-1.66, p = 0.933). Conclusion Hyperuricemia is significantly associated with increased risk of MACE in the nonobstructive CAD rather than in the obstructive CAD.
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Affiliation(s)
- Siling Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Lu Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Guoqing Yin
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Abdul-Quddus Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Xian Lv
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Cailing Feng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Tingting Shi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Fuad A Abdu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.,Department of Cardiology, Shanghai Tenth People's Hospital Chongming Branch, Shanghai, People's Republic of China
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16
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Maloberti A, Biolcati M, Ruzzenenti G, Giani V, Leidi F, Monticelli M, Algeri M, Scarpellini S, Nava S, Soriano F, Oreglia J, Sacco A, Morici N, Oliva F, Piani F, Borghi C, Giannattasio C. The Role of Uric Acid in Acute and Chronic Coronary Syndromes. J Clin Med 2021; 10:jcm10204750. [PMID: 34682873 PMCID: PMC8540994 DOI: 10.3390/jcm10204750] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/14/2022] Open
Abstract
Uric acid (UA) is the final product of the catabolism of endogenous and exogenous purine nucleotides. While its association with articular gout and kidney disease has been known for a long time, new data have demonstrated that UA is also related to cardiovascular (CV) diseases. UA has been identified as a significant determinant of many different outcomes, such as all-cause and CV mortality, and also of CV events (mainly Acute Coronary Syndromes (ACS) and even strokes). Furthermore, UA has been related to the development of Heart Failure, and to a higher mortality in decompensated patients, as well as to the onset of atrial fibrillation. After a brief introduction on the general role of UA in CV disorders, this review will be focused on UA's relationship with CV outcomes, as well as on the specific features of patients with ACS and Chronic Coronary Syndrome. Finally, two issues which remain open will be discussed: the first is about the identification of a CV UA cut-off value, while the second concerns the possibility that the pharmacological reduction of UA is able to lower the incidence of CV events.
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Affiliation(s)
- Alessandro Maloberti
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
- Correspondence: ; Tel.: +39-026-444-2141; Fax: +39-026-444-2566
| | - Marco Biolcati
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Giacomo Ruzzenenti
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Valentina Giani
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Filippo Leidi
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Massimiliano Monticelli
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Michela Algeri
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Sara Scarpellini
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
| | - Stefano Nava
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Francesco Soriano
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Jacopo Oreglia
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Alice Sacco
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Nuccia Morici
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Fabrizio Oliva
- Cardiology 1, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (S.N.); (F.S.); (J.O.); (A.S.); (N.M.); (F.O.)
| | - Federica Piani
- School of Medicine and Surgery, University of Bologna—IRCCS Policlinico S. Orsola, 40138 Bologna, Italy; (F.P.); (C.B.)
| | - Claudio Borghi
- School of Medicine and Surgery, University of Bologna—IRCCS Policlinico S. Orsola, 40138 Bologna, Italy; (F.P.); (C.B.)
| | - Cristina Giannattasio
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (M.B.); (G.R.); (V.G.); (F.L.); (M.M.); (C.G.)
- Cardiology 4, ASST GOM Niguarda Hospital, 20121 Milan, Italy; (M.A.); (S.S.)
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17
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Tao M, Ma X, Pi X, Shi Y, Tang L, Hu Y, Chen H, Zhou X, Du L, Chi Y, Zhuang S, Liu N. Prevalence and related factors of hyperuricaemia in Shanghai adult women of different ages: a multicentre and cross-sectional study. BMJ Open 2021; 11:e048405. [PMID: 34531210 PMCID: PMC8449970 DOI: 10.1136/bmjopen-2020-048405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Women in different age phases have different metabolism and hormone levels that influence the production and excretion of uric acid. We aimed to investigate the prevalence and related factors of hyperuricaemia among women in various age phases. STUDY DESIGN Observational, cross-sectional study. SETTING Data were obtained from women at three health check-up centres in Shanghai. PARTICIPANTS Adult women from three health check-up centres were recruited. Exclusion criteria were individuals with pregnancy, cancer, incomplete information. Finally, 11 601 participants were enrolled. RESULTS The prevalence rates of hyperuricaemia of total subjects were 11.15% (95% CIs 10.57% to 11.72%). The prevalence of hyperuricaemia in 18-29, 30-39, 40-49, 50-59, 60-69 and ≥70 years old was 6.41% (95% CI 4.97% to 7.86%), 5.63% (4.71% to 6.55%), 6.02% (5.01%% to 7.03%), 11.51% (10.19% to 12.82%), 16.49% (15.03% to 17.95%) and 23.98% (21.56% to 26.40%), respectively. Compared with 18-29 years old, the ORs for hyperuricaemia in other age phases were 0.870 (95% CI 0.647 to 1.170, p=0.357), 0.935 (0.693 to 1.261, p=0.659), 1.898 (1.444 to 2.493, p<0.001), 2.882 (2.216 to 3.748, p<0.001) and 4.602 (3.497 to 6.056, p<0.001), respectively. During the 18-29 years old, the related factors for hyperuricaemia were obesity and dyslipidaemia. During the 30-59 years old, the related factors were obesity, dyslipidaemia, hypertension and chronic kidney disease (CKD). Over the 60 years old, the occurrence of hyperuricaemia was mainly affected by obesity, dyslipidaemia and CKD, while hypertension cannot be an impact factor for hyperuricaemia independently of obesity and dyslipidaemia. CONCLUSION After 50 years old, the prevalence of hyperuricaemia in Shanghai women has increased significantly and reaches the peak after 70. Obesity and dyslipidaemia are two main related factors for hyperuricaemia during all ages, while diabetes mellitus and nephrolithiasis have no relationship with hyperuricaemia throughout. CKD is an independent impact factor for hyperuricaemia after 30 years old.
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Affiliation(s)
- Min Tao
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyan Ma
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoling Pi
- Department of Internal Medicine, Pudong New District Gongli Hospital, Shanghai, China
| | - Yingfeng Shi
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lunxian Tang
- Emergency Department of Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Hu
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui Chen
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xun Zhou
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lin Du
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yongbin Chi
- Department of Medical Laboratory, Pudong New District Gongli Hospital, Shanghai, China
| | - Shougang Zhuang
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Medicine, Rhode Island Hospital and Brown University School of Medicine, Providence, Rhode Island, USA
| | - Na Liu
- Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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