Prognostic value of hyperuricemia in patients with acute coronary syndrome: A meta‐analysis

• Published in: European journal of clinical investigation 2019-04, Vol.49 (4), p.e13074-n/a
• Main Authors: He, Cuifang, Lin, Peihuan, Liu, Wenbing, Fang, Kuaifa
• Format: Article
• Language: English
• Subjects: acute coronary syndrome; Acute Coronary Syndrome - complications; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - urine; Acute coronary syndromes; Biomarkers - metabolism; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cardiovascular Diseases - urine; Cause of Death; Confidence intervals; Female; Health risk assessment; Humans; Hyperuricemia; Hyperuricemia - complications; Hyperuricemia - mortality; major adverse cardiac events; Male; Meta-analysis; Middle Aged; Mortality; Patients; Prognosis; Risk analysis; Risk Factors; Subgroups; Uric acid
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1111/eci.13074

Background The prognostic significance of elevated circulating uric acid level in patients with acute coronary syndrome (ACS) is conflicting. This meta‐analysis aimed to assess the prognostic value of hyperuricemia in patients with ACS. Methods A comprehensive literature search was performed in Pubmed, Embase, VIP, CNKI and WanFang databases up to 16 June 2018. All observational studies that investigated the prognostic value of hyperuricemia in ACS patients were selected. Outcome of interests was major adverse cardiovascular events (MACEs), all‐cause mortality or cardiovascular mortality. Results A total of nine studies enrolling 8776 ACS patients were included and analysed. ACS patients with hyperuricemia had an increased risk of MACEs (risk ratio [RR]: 1.86; 95% confidence intervals [CI]: 1.47‐2.35), all‐cause mortality (RR 1.86; 95% CI: 1.49‐2.32) and cardiovascular mortality (RR: 1.74; 95% CI: 1.36‐2.22) after adjustment for the conventional risk factors. Stratified analysis showed that the prognostic significance of hyperuricemia was consistently observed in each subgroups. Conclusions This meta‐analysis suggests that hyperuricemia independently predicts MACEs and death in ACS patients. Determination of uric acid level has potential to improve risk stratification of adverse outcomes in ACS patients.