Περίληψη:
Introduction: Serum uric acid (SUA) has been depicted as a contributory causal factor in metabolic syndrome (MS), which in turn, portends unfavourable prognosis. Aim: We assessed the prognostic role of SUA in patients with and without MS. Methods: We used data from the multicentre Uric Acid Right for Heart Health study and considered cardiovascular mortality (CVM) as death due to fatal myocardial infarction, stroke, sudden cardiac death, or heart failure. Results: A total of 9589 subjects (median age 58.5 years, 45% males) were included in the analysis, and 5100 (53%) patients had a final diagnosis of MS. After a median follow-up of 142 months, we observed 558 events. Using a previously validated cardiovascular SUA cut-off to predict CVM (> 5.1 mg/dL in women and 5.6 mg/dL in men), elevated SUA levels were significantly associated to a worse outcome in patients with and without MS (all p < 0.0001) and provided a significant net reclassification improvement of 7.1% over the diagnosis of MS for CVM (p = 0.004). Cox regression analyses identified an independent association between SUA and CVM (Hazard Ratio: 1.79 [95% CI, 1.15–2.79]; p < 0.0001) after the adjustment for MS, its single components and renal function. Three specific combinations of the MS components were associated with higher CVM when increasing SUA levels were reported, and systemic hypertension was the only individual component ever-present (all p < 0.0001). Conclusion: Increasing SUA levels are associated with a higher CVM risk irrespective of the presence of MS: a cardiovascular SUA threshold may improve risk stratification. Graphic abstract: [Figure not available: see fulltext.] © 2021, The Author(s).
Συγγραφείς:
Pugliese, N.R.
Mengozzi, A.
Virdis, A.
Casiglia, E.
Tikhonoff, V.
Cicero, A.F.G.
Ungar, A.
Rivasi, G.
Salvetti, M.
Barbagallo, C.M.
Bombelli, M.
Dell’Oro, R.
Bruno, B.
Lippa, L.
D’Elia, L.
Verdecchia, P.
Mallamaci, F.
Cirillo, M.
Rattazzi, M.
Cirillo, P.
Gesualdo, L.
Mazza, A.
Giannattasio, C.
Maloberti, A.
Volpe, M.
Tocci, G.
Georgiopoulos, G.
Iaccarino, G.
Nazzaro, P.
Parati, G.
Palatini, P.
Galletti, F.
Ferri, C.
Desideri, G.
Viazzi, F.
Pontremoli, R.
Muiesan, M.L.
Grassi, G.
Masi, S.
Borghi, C.
The Working Group on Uric Acid
Cardiovascular Risk of the Italian Society of Hypertension
Λέξεις-κλειδιά:
angiotensin receptor antagonist; calcium channel blocking agent; creatinine; hemoglobin A1c; triacylglycerol; troponin T; uric acid; biological marker; uric acid, acute coronary syndrome; acute heart infarction; adult; all cause mortality; Article; atherosclerosis; cardiovascular disease; cardiovascular risk; cerebrovascular accident; chronic kidney failure; cohort analysis; coronary angiography; coronary artery atherosclerosis; diastolic blood pressure; estimated glomerular filtration rate; fatigue; glomerulus filtration rate; glucose blood level; heart arrest; heart death; heart failure; heart infarction; hypertension; metabolic syndrome X; mortality risk; multiple sclerosis; obesity; prognosis; risk assessment; sudden cardiac death; survival analysis; systolic blood pressure; waist circumference; blood; cardiovascular disease; cause of death; complication; female; follow up; human; Italy; male; metabolic syndrome X; middle aged; mortality; retrospective study; risk factor; survival rate, Biomarkers; Cardiovascular Diseases; Cause of Death; Female; Follow-Up Studies; Humans; Italy; Male; Metabolic Syndrome; Middle Aged; Prognosis; Retrospective Studies; Risk Factors; Survival Rate; Uric Acid
