Original scientific paper
Higher Serum Uric Acid on Admission Is Associated with Higher Short-term Mortality and Poorer Long-term Survival After Myocardial Infarction: Retrospective Prognostic Study
Siniša Car
; Department of Internal Medicine, Varaždin County General Hospital, Varaždin, Croatia
Vladimir Trkulja
; Department of Pharmacology, Zagreb University School of Medicine, Zagreb, Croatia
Abstract
Aim To assess serum uric acid (SUA) levels determined on
admission as a potential predictor of short-term mortality
and long-term survival in acute myocardial infarction (AMI)
patients.
Method Data for this retrospective prognostic study were
drawn from the patient database of the Varaždin County
General Hospital in Varaždin, Croatia. We included consecutive
patients with verified AMI admitted within 48 hours
since the symptom onset during the period between 1
January 1996 and 31 December 2001. Long-term survival/
mortality data were collected through direct contacts
with patients and search of the community death registries.
Relative risks (RR) and hazard ratios (HR) by 10 μmol/
L increase in SUA were determined using modified Poisson
regression with robust error variance and proportional
hazard regression, respectively.
Results A total of 621 patients (age 27-90 years, 64.7% men,
77.5% AMI with ST elevation, SUA 63-993 μmol/L) were included.
Higher SUA on admission was independently associated
with higher in-hospital mortality (RR, 1.016; 95%
confidence interval [CI], 1.001-1.031, P = 0.043) and higher
thirty-day mortality (RR, 1.016; 95% CI, 1.003-1.029,
P = 0.018). Considered covariates were demographics, preindex
event cardiovascular morbidity and treatment, onadmission
serum creatinine, total cholesterol and triglycerides,
AMI characteristics, and peak creatine phosphokinase.
Higher SUA on admission was also independently associated
with poorer long-term survival (ie, higher all-cause mortality)
(HR, 1.105; 95% CI, 1.020-1.195, P = 0.010). Considered
covariates were demographics, laboratory variables on admission,
AMI characteristics, peak creatine phosphokinase,
acute complications, and treatment at discharge.
Conclusion Higher serum uric acid determined on admission
is associated with higher in-hospital mortality and thirty-
day mortality and poorer long-term survival after AMI.
Keywords
serum uric acid; acute myocardial infarction; mortality; all-cause mortality
Hrčak ID:
48554
URI
Publication date:
15.12.2009.
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