Uric Acid Levels Predict Death in Acute Coronary Syndrome

Elevated levels of uric acid are predictive of one-year mortality in patients with acute coronary syndrome (ACS), according to a new study.

Researchers at the German Heart Center (Deutsches Herzzentrum; Munich, Germany) conducted a study involving 5,124 patients with ACS who underwent percutaneous coronary intervention (PCI) to evaluate whether uric acid levels have any prognostic value. The participants were classified into four uric acid quartiles: quartile 1 (1.3 to <5.3 mg/dL), quartile 2 (5.3 to <6.3 mg/dL), quartile 3 (6.3 to <7.5 mg/dL), and quartile 4 (7.5 to 18.4 mg/dL). Of the participants, 1,629 had acute ST-segment elevation myocardial infarction (STEMI), 1,332 had acute non-STEMI, and 2,163 had unstable angina. The primary end point was one-year mortality.

The results showed that during follow-up, there were 450 deaths: 80 deaths in quartile 1, 77 in quartile 2, 72 in quartile 3, and 221 in quartile 4. The researchers found that uric acid measurement improved the discriminatory power of the predictive model regarding one-year mortality. After adjustment for traditional cardiovascular (CV) risk factors, renal function, and inflammatory status, the association between uric acid and mortality remained significant, with a 12% increase in the adjusted risk for one-year mortality for every 1 mg/dL increase in the uric acid level. The study was published in the May 1, 2012, issue of the American Journal of Cardiology.

“Elevated levels of uric acid are an independent predictor of one-year mortality across the whole spectrum of patients with acute coronary syndromes treated with percutaneous coronary intervention,” concluded lead author Gjin Ndrepepa, MD, and colleagues.

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