Izvorni znanstveni članak
On-admission serum uric acid predicts outcomes after acute myocardial infarction: systematic review and metaanalysis of prognostic studies
Vladimir Trkulja
; Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia
Siniša Car
; Cardiology unit, Department of Internal Medicine, General Hospital Varaždin, Varaždin, Croatia
Sažetak
Aim To evaluate the prognostic value of serum uric acid
(SUA) in acute myocardial infarction (AMI) patients.
Methods Systematic review and random-effects metaanalysis
of prognostic studies assessing AMI outcomes
(death, major adverse cardiac events, MACE) in relation to
on-admission SUA.
Results Nine studies (7655 patients) were identified, 6 in
the ST-segment elevation AMI patients treated with invasive
revascularization and three in mixed AMI type cohorts
with variable reperfusion strategies. “High” SUA (vs “low,”
different cut-offs) was univariately associated with higher
short-term mortality (8 studies/6805 patients; odds ratio
[OR], 3.24; 95% confidence interval [CI], 2.47-4.27) and
incidence of MACE (7/6467; OR, 2.46; 95% CI, 1.84-3.27,
moderate heterogeneity, mild bias), and with higher medium-
term mortality (5/5194; OR, 2.69; 95% CI, 2.00-3.62,
moderate heterogeneity, mild bias) and MACE (4/4299;
OR, 1.93; 95% CI, 1.36-2.74, high heterogeneity, mild bias).
It was independently associated with a higher short-term
(4/3625; OR, 2.26, 95% CI, 1.85-2.77) and medium/longterm
(3/2683; hazard ratio [HR], 1.30; 95% CI 1.01-1.68,
moderate heterogeneity, mild bias) occurrence of poor
outcomes (death/MACE). As a continuous variable (by 50
μmol/L), higher SUA was also independently associated
with poorer medium/long-term outcomes (4/3533; HR,
1.19; 95% CI, 1.03-1.37, high heterogeneity, mild bias). All
individual study effects (unadjusted or adjusted) were in
the same direction, but differed in size. Heterogeneity was
mainly due to the included AMI type and/or definition of
MACE. All bias-corrected pooled effects remained significant.
Conclusion Based on the available data, high(er) on-admission
SUA independently predicts worse short-term
and medium/long-term outcomes after AMI. However, the
number of data are modest and additional prospective
studies are warranted
Ključne riječi
Hrčak ID:
83878
URI
Datum izdavanja:
15.4.2012.
Posjeta: 1.376 *