Association of serum uric acid level with mortality and morbidity of patients with acute ST-elevation myocardial infarction

Abstract

Introduction: Investigating the clinical impact of serum uric acid (UA) and its lowering agents on the complications and mortality of acute ST-elevation myocardial infarction (STEMI) can open a new era in STEMI treatment. The aim of this study was to evaluate the effect of on admission serum UA level on the mortality and morbidity of patients admitted with STEMI.
Methods: A number of 608 patients with STEMI were enrolled in this study from December 21, 2012 until February 19, 2014. Patients were followed for 20 months. Male to female ratio was 2.53, and the mean age of patients was 62.6±13.4. The relationship between the level of UA and patients’ mortality and morbidity, left ventricular ejection fraction (LVEF), atrial and ventricular arrhythmia was analyzed.
Results: Patients with high serum UA level had higher Killip class after STEMI (P = 0.001). Mean LVEF was measured to be 39.5 ± 9.6 in normal UA group and 34.6 ± 11.6 in high UA group (P = 0.001). In comparison with normal UA group, high UA group had significantly higher cTnI (2.68 ± 0.09 vs 4.09 ± 0.42, respectively, P = 0.001), increased blood pressure (P = 0.009), and higher atrial fibrillation (AF) occurrence (P = 0.03), but no association was seen between ventricular tachycardia and serum UA level. Short term and midterm mortality were not different in two groups (P = 0.44 and 0.31, respectively).
Conclusion: In the current study, high serum UA level in patients with acute myocardial infarction (MI) was not associated with higher in-hospital or midterm mortality, but it was associated with lower LVEF, higher Killip class, elevated cTnI, creatinine, triglyceride, and higher AF.

Keywords: Acute Myocardial Infarction, Serum Uric Acid, Left Ventricular Systolic Dysfunction, Cardiac Troponin I