Serum uric acid levels in patients of acute myocardial infarction
Keywords:Acute myocardial infarction, Congestive heart failure, Killip class, Uric acid
Background: Following Myocardial Infarction some proteins and enzymes, CPK-MB/ Troponin-I, T, are released into the blood from the necrotic heart muscle. Serum Uric Acid (SUA) may be a risk factor and negative prognostic marker for cardiovascular diseases. Aim of the study was to study serum uric acid levels in patients of acute Myocardial infarction with congestive heart failure, its relation with stages of congestive heart failure as per Killip classification and the role of serum uric acid levels as a marker of mortality.
Methods: The case control study was conducted on 120 patients divided into two groups. Group A included 60 patients of acute Myocardial infarction. Group A was further divided into two categories. One includes 30 patients of with congestive heart failure and another includes 30 patients without congestive heart failure. Group B consists of 60 control patients. Serum uric acid levels were measured in Group A on 1st, 3rd and 7th day of hospital admission and in Group B on 1st day.
Results: The study showed females have higher degree of hyperuricemia than males. SUA was significantly higher in patients of acute myocardial infarction than control group patients. SUA were also higher in patients with history of IHD, in patients with BNP >100 and it correlates with Killip class and mortality rates. Patients of acute myocardial infarction with diabetes mellitus had higher degree of hyperuricemia than nondiabetic and control group. No significant difference in SUA levels were observed with regard to age, alcohol intake, lipid profile, ejection fraction and hypertension.
Conclusions: In acute myocardial infarction, patients with hyperuricemia had higher mortality and may be considered as poor prognostic biomarker.
Harris P, Jenner FP, Kumar S. Serum uric acid as a marker of left ventricular failure in acute myocardial infarction. Age. 2015;57(9.698):27.
Nadkar MY, Jain VI. Serum uric acid in acute myocardial infarction. JAPI. 2008 Oct;56(10):759-62.
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.
Sokhanavar S, Maleki A. Blood uric acid levels according to cardiovascular disease risk factors in patients with myocardial infarction. Iranian Heart J. 2007;8(1):43-5.
Kuzuya M, Ando F, Iguchi A, Shimokata H. Effect of aging on serum uric acid levels: longitudinal changes in a large Japanese population group. The Journals of Gerontology Series A: Biol Sci Med Sci. 2002 Oct 1;57(10):M660-4.
Freedman DS, Williamson DF, Gunter EW, Byers T. Relation of serum uric acid to mortality and ischemic heart disease: the NHANES I Epidemiologic Follow-up Study. Am J Epidemiol. 1995 Apr 1;141(7):637-44.
Culleton BF, Larson MG, Kannel WB, Levy D. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Annal Int Med. 1999 Jul 6;131:7-13.
Gordon T, Kannel WB. Drinking and its relation to smoking, BP, blood lipids, and uric acid: the Framingham Study. Archiv Int Med. 1983 Jul 1;143(7):1366-74.
Liu SC, Xia L, Zhang J, Lu XH, Hu DK, Zhang HT, et al. Gout and risk of myocardial infarction: a systematic review and meta-analysis of cohort studies. PLoS One. 2015 Jul 31;10(7):e0134088.
Katsiki N, Papanas N, Fonseca VA, Maltezos E, Mikhailidis DP. Uric acid and diabetes: is there a link?. Curr Pharmaceutical Design. 2013 Aug 1;19(27):4930-7.
Kojima S, Sakamoto T, Ishihara M, Kimura K, Miyazaki S, Yamagishi M, et al. Prognostic usefulness of serum uric acid after acute myocardial infarction (the Japanese Acute Coronary Syndrome Study). Am J Cardiol. 2005 Aug 15;96(4):489-95.
Shetty S, Rao AH, Sampath Kumar AK, Rama Prakasha S. Serum Uric Acid as a prognostic biomarker and its correlation with Killip Class in Acute Myocardial Infarction. Int J Biomed Res. 2013;4(7):312-16.
Agrawal S, Aundhkar SC, Patange A, Panpalia NG, Jain S, Garg R. Evaluate the role of serum uric acid in acute myocardial infarction as a prognostic marker. Int J Health Sci Res. 2014;4(5):120-8.
Kumar B, Jassal B, Gupta RS, Bedi GK, Kapila S. Serum Uric Acid as an Indicator of Bad Prognosis in Myocardial Infarction. IntJ Med Dental Sci. 2018 Jan 12;4(2):775-84.
Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347(3):161-7.