Key result
Hyperuricemia links to higher MACE in stable CAD with renal dysfunction but lacks independent predictive value.
Why the study?
Does hyperuricemia predict major adverse cardiac events in stable coronary artery disease patients with or without renal dysfunction?
Cohort (n=1,169)
Does hyperuricemia predict major adverse cardiac events in stable coronary artery disease patients with or without renal dysfunction?
p-value: p=0.19 (without renal dysfunction); 0.003 (with renal dysfunction)
Hyperuricemia is associated with increased cardiac events in stable CAD patients with renal dysfunction, but it is not an independent predictor, suggesting it is a risk marker rather than a causal factor.
Hyperuricemia should not guide CV risk reduction absent renal dysfunction; challenges broad targeting and leaves open stratified intervention trials.
. The primary endpoint was the occurrence of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and hospitalization for heart failure. Overall, 1169 patients were included, with a mean age of 69.9 ± 9.8 years; 80.3% were male. Hyperuricemia was present in 10.2% of patients without renal dysfunction (n = 616) and 32.0% of those with renal dysfunction (n = 553). The median follow-up period was 5.0 years (interquartile range: 2.1-8.6 years). Among patients without renal dysfunction, no significant difference was observed in MACE occurrence between the high- and low-UA groups (log-rank p = 0.19). In contrast, among patients with renal dysfunction, the incidence of MACE was higher in the high-UA group than in the low-UA group (log-rank p = 0.003). However, multivariable analyses indicated that high UA was not an independent predictor of MACE, even among patients with renal dysfunction. Hyperuricemia may serve as a useful marker for cardiac events, with a more apparent association in patients with renal dysfunction; however, UA itself may not have a direct causal role.
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Kondo et al. (2026) conducted a cohort in Stable coronary artery disease (n=1,169). Hyperuricemia (high uric acid) vs. Low uric acid was evaluated on Major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and hospitalization for heart failure (p=0.19 (without renal dysfunction); 0.003 (with renal dysfunction)). Hyperuricemia was associated with higher MACE incidence in stable CAD patients with renal dysfunction (log-rank p=0.003) but not without (p=0.19), and was not an independent predictor.
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