Impact of serum uric acid levels on cardiovascular events and quality of life in patients with chronic coronary syndromes: Insights from a contemporary, prospective, nationwide registry

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2022-02, Vol.32 (2), p.393-401
• Main Authors: De Luca, Leonardo, Gulizia, Michele M., Gabrielli, Domenico, Meessen, Jennifer, Mattei, Luisa, D'Urbano, Maurizio, Colivicchi, Furio, Temporelli, Pier L., Borghi, Claudio, Desideri, Giovambattista
• Format: Article
• Language: English
• Subjects: Chronic coronary syndromes; Heart Failure - diagnosis; Heart Failure - epidemiology; Humans; Hyperuricemia; Management; Outcome; Quality of Life; Real-world evidence; Registries; Risk Factors; Syndrome; Treatment; Uric Acid
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2021.09.034

Hyperuricemia is a metabolic disorder that has been associated with adverse cardiovascular (CV) events. Using the data from a nationwide, prospective registry on patients with chronic coronary syndromes (CCS), we assessed the impact of serum uric acid (SUA) levels on quality of life (QoL) and major adverse CV events (MACE), a composite of CV death and hospitalization for myocardial infarction, heart failure (HF), angina or revascularization at 1-year. Among the 5070 consecutive CCS patients enrolled in the registry, levels of SUA were available for 2394 (47.2%). Patients with SUA levels available at baseline were grouped as low tertile (n = 860; 4.3 [3.7–4.7] mg/dL), middle tertile (n = 739; 5.6 [5.3–5.9] mg/dL) and high tertile (n = 795; 7.1 [6.7–7.9] mg/dL). At 1 year, the incidence of MACE was 3.7%, 4.1% and 6.8% for low, middle and high tertiles, respectively (p = 0.005 for low vs high tertile). Patients in the high tertile of SUA had a significantly higher rate of CV mortality (1.4% vs 0.4%; p = 0.05) and hospital admission for HF (2.8% vs 1.6%; p = 0.03) compared to the low tertile. However, hyperuricemia did not result as an independent predictor of MACE at multivariable analysis [hazard ratio: 1.27; 95% confidence intervals: 0.81–2.00; p = 0.3]. In this contemporary, large cohort of CCS, those in the high tertile of SUA had a greater burden of CV disease and worse QoL. However, SUA did not significantly influence the higher rate of CV mortality, hospitalization for HF and MACE observed in these patients during 1-year follow-up. •Patients with CCS in the high tertile of serum uric acid (SUA) levels had an elevated burden of cardiovascular disease.•The quality of life of patients in the high tertile of SUA levels was also worsen compared to those in lower quartiles.•Serum uric acid levels did not significantly impact on CV mortality, hospitalization for HF and MACE at 1-year.