DOI: http://dx.doi.org/10.18203/2349-3933.ijam20173222

Serum uric acid levels in acute myocardial infarction

Padma V., Amogh Banupriya

Abstract


Background: Higher uric acid is a negative prognostic factor in patients with mild to severe heart failure. Studies have shown that there is a close correlation between serum uric acid concentration and Killip classification in patients of acute myocardial infarction and uric acid levels are higher in patients with higher Killips class.

Methods: We studied 100 patients with acute myocardial infarction and compared with 100 controls. Serum uric acid level was measured on day 0, 3 and 7 of MI and results were analysed.

Results: Average uric acid level in male cases was 5.6 and female cases was 5.2, male controls were 4.2 and female controls was 3.6. Females had a higher mortality when compared with male patients. One female died due to MI on day 0, one male and two females died on day 3 and four males and four females died on day 7. All patients who died had higher uric acid levels.

Conclusions: Serum uric acid levels are higher in patients of acute myocardial infarction as compared to normal healthy persons. Serum uric levels increases in patients with higher Killip class. Combination of Killip class and serum uric acid level after acute myocardial infarction is a good predictor of mortality after acute myocardial infarction.


Keywords


Heart failure, Killips class, Myocardial infarction, Uric acid

Full Text:

PDF

References


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;11:816-26.

Brodov Y, Chouraqui P, Goldenberg I, Boyko V, Mandelzweig L, Behar S. Serum uric acid for risk stratification of patients with coronary artery disease. Cardiol. 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.

Wannamethee SG, Shaper AG, Whincup PH. Serum urate and the risk of major coronary heart disease events. Heart. 1997;78:147-53.

Culleton BF, Larson MG, Kannel WB, Levy B. Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med. 1999;131:7-13.

Bickel C, Rupprecht HJ, Blankenberg S, Rippin G, Hafner G, et al. Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease. Am J Cardiol. 2002;89:12-17.

Patetsios P, Song M, Shutze WP, Pappas C, Rodino W, Ramirez JA, et al. Identification of uric acid and xanthine oxidase in atherosclerotic plaque. Am J Cardiol. 2001;88(2):188-91.

Alderman M, Aiyer KJ. Uric acid: role in cardiovascular disease and effects of losartan. Curr Med Res Opin. 2004;20:369-79.

Heinig M, Johnson RJ. Role of uric acid in hypertension, renal disease, and metabolic syndrome. Clevel and Clinic J Med. 2006;73(12):1059-64.

Castelli P, Condemi AM, Brambillasca C. Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery. J Cardiovasc Pharmacol. 1995;25:119-25.

Ochiai ME, Barretto AC, Oliveira MT. Uric acid renal excretion and renal insufficiency in decompensated severe heart failure. Eur J Heart Fail. 2005;7:468-74.

Hare JM, Johnson RJ. Uric acid predicts clinical outcomes in heart failure: insights regarding the role of xanthine oxidase and uric acid in disease pathophysiology. Circulation. 2003;107:1951-3.

Aringer M, Graessler J. Understanding deficient elimination of uric acid. Lancet. 2008;372(9654): 1929-30.

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;96(4):489-95.

Bickel C, Rupprecht HJ, Blankenberg S, Rippin G, Hafner G, Daunhauer A, et al. Serum uric acid as an independent predictor of mortality in patients with angiographically proven coronary artery disease. Am J Cardiol. 2002;89(1):12-7

Olexa P, Olexová M, Gonsorcík J, Tkác I, Kisel'ová J, Olejníková M. Uric acid - a marker for systemic inflammatory response in patients with congestive heart failure?. Wiener Klinische Wochenschrift. 2002;114(5-6):211-5.

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 Soc Nephrol. 2002;13:2888-97.

Lippi G, Montagnana M, Luca Salvagno G, Targher G, Cesare Guidi G. Epidemiological association between uric acid concentration in plasma, lipoprotein (a) and the traditional lipid profile. Clin Cardiol. 2010;33:76-80.