DOI: http://dx.doi.org/10.18203/2349-3933.ijam20182108

Study of serum uric acid level as a prognostic marker in acute ST elevation myocardial infarction patients

Suresh Kumar Behera, Akshaya Kumar Samal

Abstract


Background: The study was conducted to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with ST elevation myocardial infarction (STEMI) and to assess any influence of serum uric acid levels on in-hospital mortality in STEMI patients.

Methods: Authors evaluated 250 consecutive (STEMI) patients who were hospitalized within 24 hours of symptom onset from September 2015 to august 2017. Detailed history, physical examination was done as per a structured proforma and necessary laboratory investigations were done.

Results: There was significant difference in mean serum uric acid level between diabetic and non-diabetic population. There was significant difference in mean uric acid level between hypertensive and non-hypertensive population. Serum uric acid level was high among STEMI patients with Killip class III and IV and low among patients with Killip class I and II. The higher the uric acid level was, the higher was the percentage of mortality during 5 days hospital course.

Conclusions: Patients of higher Killip class had higher levels of serum uric acid as compared to patients of lower Killip class. Serum uric acid level when combined with Killip class is a good predictor of severity of heart failure and short-term mortality after STEMI.


Keywords


Diabetes, Hypertension, Killip class, Mortality, STEMI, Serum uric acid

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References


Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. Int J Cardiol. 2013;168:934-45.

Krishnan E, Pandya BJ, Chung L, Dabbous O. Hyperuricemia and the risk for subclinical coronary atherosclerosis-data from a prospective observational cohort study. Arthritis Res Ther. 2011;13:R66.

Baker JF, Krishnan E, Chen L, Schumacher HR. Serum uric acid and cardiovascular disease: recent developments, and where do they leave us? Am J Med. 2005;118:816-26.

Krishnan E. Gout and coronary artery disease: epidemiologic clues. Curr Rheumatol Rep. 2008;10:249-55.

Brodov Y, Chouraqui P, Goldenberg I, Boyko V, Mandelzweig L, Behar S. Serum uric acid for risk stratification of patients with coronary artery disease. Cardiology. 2009;114:300-5.

Bae MH, Lee JH, Lee SH, Park SH, Yang DH, Park HS, et al. Serum uric acid as an independent and incremental prognostic marker in addition to N-terminal pro-B-type natriuretic peptide in patients with acute myocardial infarction. Circ J. 2011;75:1440-77.

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD et al. Third universal definition of myocardial infarction. Circulation. 2012;126:2020-35.

Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, Pandey MR et al. Risk Factors for Early Myocardial Infarction in South Asians Compared With Individuals in Other Countries. JAMA. 2007;297(3):286-94.

Nadkar MY, Jain VI. Serum Uric Acid in Acute Myocardial Infarction. JAPI. 2008;56:759-62.

Sharma LCJ, Kumar BMS. Clinical and angiographic profile of aircrew with coronary heart disease undergoing cardiac evaluation before being reflighted. IJASM. 2002;46(2):32-8.

Jafary MH, Samad A, Ishaq M, Awaid SA, Ahmad M, Vohra EA, et al. Profile of AMI in Pakistan. Pak J Med Sci. 2007;23(4):485-9.

Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003;290(7):898-904.

Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the interheart study): Case-control study. Lancet. 2004;364(9438):937-52.

Kojima S, Sakamoto T, Ishihara M, Kimura K, Miyazaki S, Yamagishi M, et al. Prognostic usefulness of serum uric acid after acute myocardial infarction (Japanese Acute Coronary Syndrome Study). Am J Cardiol. 2005;96:489-95.

Safi AJ, Mahmood R, Khan MA. Association of serum Uric Acid with type II diabetes mellitus. J Postgrad Med Inst. 2004;18:59-63.

Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F, et al. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health. 2004;4:9.

Kang DH, Nakagawa T, Feng L, Watanabe S, Han L, Mazzali M, et al. A role for uric acid in the progression of renal disease. J Am SocNephrol. 2002;13:2888-97.

Sokhanavar S, Maleki A. Blood uric acid levels according to cardiovascular disease risk factors in patients with myocardial infarction. Iranian Heart Journal 2007;8(1):43-5.

Jacobs D. Hyperuricaemia and myocardial infarction. S Afr Med J. 1972;46:367-9.

Fang J, Alderman MH. Serum uric acid and cardiovascular mortality. JAMA. 2000;283:2404-10.