Uric acid and survival in chronic heart failure: Validation and application in metabolic, functional, and hemodynamic staging

Serum uric acid (UA) could be a valid prognostic marker and useful for metabolic, hemodynamic, and functional (MFH) staging in chronic heart failure (CHF). For the derivation study, 112 patients with CHF (age 59+/-12 years, peak oxygen consumption [Vo2] 17+/-7 mL/kg per minute) were recruited. In se...

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Published in:Circulation (New York, N.Y.) N.Y.), 2003-04, Vol.107 (15), p.1991-1997
Main Authors: ANKER, Stefan D, DOEHNER, Wolfram, SEGAL, Robert, OSTERZIEL, Karl Josef, LEYVA, Francisco, HETZER, Roland, PONIKOWSKI, Piotr, COATS, Andrew J. S, RAUCHHAUS, Mathias, SHARMA, Rakesh, FRANCIS, Darrel, KNOSALLA, Christoph, DAVOS, Constantinos H, CICOIRA, Mariantonietta, SHAMIM, Waqar, KEMP, Michel
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers - blood
Cardiology. Vascular system
Chronic Disease
Comorbidity
Female
Follow-Up Studies
Heart
Heart Failure - diagnosis
Heart Failure - mortality
Heart Failure - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Hemodynamics
Humans
Hyperuricemia - blood
Hyperuricemia - diagnosis
Male
Medical sciences
Middle Aged
Models, Statistical
Oxygen Consumption
Predictive Value of Tests
Prognosis
Risk Factors
ROC Curve
Sensitivity and Specificity
Stroke Volume
Survival Rate
Uric Acid - blood
Xanthine Oxidase - metabolism
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cites cdi_FETCH-LOGICAL-c358t-55bc67a3e4742be9cf69e53fb6ec7c21feace06e38095f6220c784f2660e83c93
container_end_page 1997
container_issue 15
container_start_page 1991
container_title Circulation (New York, N.Y.)
container_volume 107
creator ANKER, Stefan D
DOEHNER, Wolfram
SEGAL, Robert
OSTERZIEL, Karl Josef
LEYVA, Francisco
HETZER, Roland
PONIKOWSKI, Piotr
COATS, Andrew J. S
RAUCHHAUS, Mathias
SHARMA, Rakesh
FRANCIS, Darrel
KNOSALLA, Christoph
DAVOS, Constantinos H
CICOIRA, Mariantonietta
SHAMIM, Waqar
KEMP, Michel
description Serum uric acid (UA) could be a valid prognostic marker and useful for metabolic, hemodynamic, and functional (MFH) staging in chronic heart failure (CHF). For the derivation study, 112 patients with CHF (age 59+/-12 years, peak oxygen consumption [Vo2] 17+/-7 mL/kg per minute) were recruited. In separate studies, we validated the prognostic value of UA (n=182) and investigated the relationship between MFH score and the decision to list patients for heart transplantation (n=120). In the derivation study, the best mortality predicting UA cutoff (at 12 months) was 565 micromol/L (9.50 mg/dL) (independently of age, peak Vo2, left ventricular ejection fraction, diuretic dose, sodium, creatinine, and urea; Por=565 micromol/L predicted mortality (hazard ratio, 7.14; Por=565 micromol/L, left ventricular ejection fraction
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In separate studies, we validated the prognostic value of UA (n=182) and investigated the relationship between MFH score and the decision to list patients for heart transplantation (n=120). In the derivation study, the best mortality predicting UA cutoff (at 12 months) was 565 micromol/L (9.50 mg/dL) (independently of age, peak Vo2, left ventricular ejection fraction, diuretic dose, sodium, creatinine, and urea; P&lt;0.0001). In the validation study, UA &gt;or=565 micromol/L predicted mortality (hazard ratio, 7.14; P&lt;0.0001). In 16 patients (from both studies) with UA &gt;or=565 micromol/L, left ventricular ejection fraction &lt;or=25% and peak Vo2 &lt;or=14 mL/kg per min (MFH score 3), 12-month survival was lowest (31%) compared with patients with 2 (64%), 1 (77%), or no (98%, P&lt;0.0001) risk factor. In an independent study, 51% of patients with MFH score 2 and 81% of patients with MFH score 3 were listed for transplantation. 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In an independent study, 51% of patients with MFH score 2 and 81% of patients with MFH score 3 were listed for transplantation. The positive predictive value of not being listed for heart transplantation with an MFH score of 0 or 1 was 100%. High serum UA levels are a strong, independent marker of impaired prognosis in patients with moderate to severe CHF. The relationship between serum UA and survival in CHF is graded. MFH staging of patients with CHF is feasible.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>12707250</pmid><doi>10.1161/01.CIR.0000065637.10517.A0</doi><tpages>7</tpages></addata></record>
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subjects Biological and medical sciences
Biomarkers - blood
Cardiology. Vascular system
Chronic Disease
Comorbidity
Female
Follow-Up Studies
Heart
Heart Failure - diagnosis
Heart Failure - mortality
Heart Failure - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Hemodynamics
Humans
Hyperuricemia - blood
Hyperuricemia - diagnosis
Male
Medical sciences
Middle Aged
Models, Statistical
Oxygen Consumption
Predictive Value of Tests
Prognosis
Risk Factors
ROC Curve
Sensitivity and Specificity
Stroke Volume
Survival Rate
Uric Acid - blood
Xanthine Oxidase - metabolism
title Uric acid and survival in chronic heart failure: Validation and application in metabolic, functional, and hemodynamic staging
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