Hyperuricemia and untreated gout are poor prognostic markers among those with a recent acute myocardial infarctionReportar como inadecuado

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Arthritis Research and Therapy

, 14:R10

First Online: 17 January 2012Received: 13 July 2011Revised: 29 November 2011Accepted: 17 January 2012


IntroductionPatients with a history of myocardial infarction MI are often at risk for complications, including subsequent MI and death. Use of prognostic markers may aid in preventing these poor outcomes. Hyperuricemia is associated with increased risk for coronary heart disease CHD and-or mortality; however, it is unknown if serum urate sUA levels predict outcomes in patients with previous MI. The purpose of this study was to assess hyperuricemia as a biomarker of CHD outcomes in such patients.

MethodsThese were post hoc analyses of datasets from the Aspirin Myocardial Infarction Study, a 1:1 randomized, double-blind clinical trial, conducted from 1975 to 1979, that examined mortality rates following daily aspirin administration over three years in individuals with documented MI. The primary outcome measures were all-cause death, CHD mortality, coronary incidence, and stroke by quartile of baseline sUA. A sub-analysis of all outcome measures in the presence or absence of gouty arthritis was also performed.

ResultsOf 4,524 enrolled participants, data on 4,352 were analyzed here. All outcomes were greatest for patients in the fourth sUA quartile. In multivariate regression models, the hazard ratios HR for patients in the highest quartile were 1.88 for all-cause mortality 95% confidence interval CI, 1.45 to 2.46, 1.99 for CHD mortality 95% CI, 1.49 to 2.66, and 1.36 for coronary incidence 95% CI, 1.08 to 1.70. Participants with untreated gout had an adjusted hazard ratio ranging from 1.5 to 2.0 all P < 0.01 for these outcomes. Participants with gout who were receiving treatment did not exhibit this additional risk.

ConclusionssUA and untreated gout may be independent prognostic markers for poor all-cause and CHD mortality in patients with recent acute MI.

AbbreviationsACSacute coronary syndrome

AMISAspirin Myocardial Infarction Study

CHDcoronary heart disease

CIconfidence interval

CRPC-reactive protein

CVDcardiovascular disease

HRhazard ratio

LDLlow density lipoprotein

MImyocardial infarction

NHLBINational Heart Lung Blood Institute

sUAserum urate

ULTurate lowering therapy

XOxanthine oxidase.

Electronic supplementary materialThe online version of this article doi:10.1186-ar3684 contains supplementary material, which is available to authorized users.

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Autor: Eswar Krishnan - Bhavik J Pandya - Bharathi Lingala - Ali Hariri - Omar Dabbous

Fuente: https://link.springer.com/

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