Τίτλος:
Hyperuricaemia, chronic kidney disease, and outcomes in heart failure: Potential mechanistic insights from epidemiological data
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim To determine if the association between hyperuricaemia and poor outcomes in heart failure (HF) varies by chronic kidney disease (CKD).Methods and resultsOf the 2645 systolic HF patients in the Beta-Blocker Evaluation of Survival Trial with data on baseline serum uric acid, 1422 had hyperuricaemia (uric acid <6 mg/dL for women and <8 mg/dL for men). Propensity scores for hyperuricaemia, estimated for each patient, were used to assemble a matched cohort of 630 pairs of patients with and without hyperuricaemia who were balanced on 75 baseline characteristics. Associations of hyperuricaemia with outcomes during 25 months of median follow-up were examined in all patients and in those with and without CKD (estimated glomerular filtration rate of <60 mL/min/1.73 m2). Hyperuricaemia-associated hazard ratios (HRs) and 95 confidence intervals (CI) for all-cause mortality and HF hospitalization were 1.44 (1.121.85, P 0.005) and 1.27 (1.021.58, P 0.031), respectively. Hazard ratios (95 CIs) for all-cause mortality among those with and without CKD were 0.96 (0.701.31, P 0.792) and 1.40 (1.081.82, P 0.011), respectively (P for interaction, 0.071), and those for HF hospitalization among those with and without CKD were 0.99 (0.741.33, P 0.942) and 1.49 (1.191.86, P 0.001), respectively (P for interaction, 0.033).Conclusion Hyperuricaemia has a significant association with poor outcomes in HF patients without CKD but not in those with CKD, suggesting that hyperuricaemia may predict poor outcomes when it is primarily a marker of increased xanthine oxidase activity, but not when it is primarily due to impaired renal excretion of uric acid. © 2010 The Author.
Συγγραφείς:
Filippatos, G.S.
Ahmed, M.I.
Gladden, J.D.
Mujib, M.
Aban, I.B.
Love, T.E.
Sanders, P.W.
Pitt, B.
Anker, S.D.
Ahmed, A.
Περιοδικό:
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
Λέξεις-κλειδιά:
allopurinol; antiarrhythmic agent; anticoagulant agent; bucindolol; digitalis; dipeptidyl carboxypeptidase inhibitor; loop diuretic agent; uric acid; vasodilator agent, adult; article; chronic kidney disease; controlled study; disease association; female; follow up; glomerulus filtration rate; hospitalization; human; hyperuricemia; major clinical study; male; mortality; outcome assessment; priority journal; risk assessment; systolic heart failure; uric acid blood level, Aged; Canada; Chronic Disease; Female; Glomerular Filtration Rate; Heart Failure; Hospitalization; Humans; Hyperuricemia; Kaplan-Meier Estimate; Kidney Diseases; Male; Middle Aged; Multicenter Studies as Topic; Prognosis; Propensity Score; Randomized Controlled Trials as Topic; United States; Xanthine Oxidase
DOI:
10.1093/eurheartj/ehq473
