Association between uric acid-to-albumin ratio and clinical outcomes in patients with hypertrophic cardiomyopathy: A retrospective observational study

Objective To evaluate the association between the uric acid-to-albumin ratio and adverse clinical outcomes in patients with hypertrophic cardiomyopathy. Methods This retrospective, observational single-center study included 124 patients with hypertrophic cardiomyopathy (58 with obstructive and 66 with nonobstructive hypertrophic cardiomyopathy) and 60 age- and sex-matched healthy controls. Baseline clinical, laboratory, and echocardiographic parameters were analyzed. A composite endpoint comprising cardiovascular death, heart failure hospitalization, and appropriate implantable cardioverter-defibrillator shocks was assessed. Logistic regression analyses were used to identify independent associations, and receiver operating characteristic analysis was performed to evaluate discriminative ability. Results The uric acid-to-albumin ratio was higher in patients with obstructive hypertrophic cardiomyopathy than in those with nonobstructive hypertrophic cardiomyopathy and controls (1.56 ± 0.15 vs 1.21 ± 0.08 vs 1.15 ± 0.11; p < 0.001). Adverse events occurred in 32 patients with hypertrophic cardiomyopathy (25.8%) and were more frequent in the obstructive group (34.5% vs 18.2%; p = 0.038). In multivariable analysis, higher uric acid-to-albumin ratio (per 0.1 increase; OR, 1.50; 95% confidence interval: 1.18–1.90; p = 0.001) and septal thickness (OR, 1.65; 95% confidence interval: 1.30–2.10; p < 0.001) were independently associated with adverse outcomes. Receiver operating characteristic analysis yielded an area under the curve of 0.717 ( p < 0.001). Conclusions Elevated uric acid-to-albumin ratio was independently associated with adverse outcomes in hypertrophic cardiomyopathy and may serve as a simple and inexpensive biomarker for risk stratification.