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Prognostic Significance of Hyperuricemia in Patients with Different Types of Renal Dysfunction and Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

2010; Karger Publishers; Volume: 116; Issue: 2 Linguagem: Inglês

10.1159/000314660

1660-2110

Jacek Kowalczyk, Paweł Francuz, Ryszard Swoboda, Radosław Lenarczyk, Beata Średniawa, Adam Gołda, Tomasz Kurek, Michał Mazurek, Tomasz Podolecki, Lech Poloński, Zbigniew Kalarus,

Takotsubo Cardiomyopathy and Associated Phenomena

<i>Aim:</i> This study evaluated the impact of hyperuricemia (HUR) on outcome in patients with different types of impaired renal function (IRF) and acute myocardial infarction (AMI) treated invasively. <i>Methods:</i> Out of 3,593 consecutive AMI patients treated invasively, 1,015 IRF patients were selected. The IRF group consisted of patients with baseline kidney dysfunction (BKD group) and/or patients with contrast-induced nephropathy (CIN group). HUR was defined as a serum uric acid concentration (SUAC) >420 µmol/l (>7 mg/dl). Independent predictors of death and major adverse cardiovascular events (MACE) were selected by the multivariate Cox-regression model. <i>Results:</i> Remote mortality rates were higher in HUR patients: IRF (32.7 vs. 18.6%), BKD (41.3 vs. 25.9%), CIN (35.4 vs. 16.7%); all p < 0.001. HUR was an independent predictor of death in BKD (hazard ratio (HR) 1.38, p < 0.05). Each 100-µmol/l increase in SUAC was associated with a significant increase of HR for mortality: 1.087 in IRF patients, 1.108 in BKD patients, 1.128 in CIN patients; all p < 0.05. Remote major adverse cardiovascular event rates were higher in HUR patients: IRF (55.4 vs. 48.9%), CIN (56.8 vs. 48%); both p < 0.05. <i>Conclusions:</i> In AMI patients treated invasively, an increase in SUAC is an independent predictor of death within all types of renal dysfunction; HUR defined as SUAC >420 µmol/l (>7 mg/dl) is a predictor only in BKD patients.