Key result
Serum uric acid levels >400 mmol/L increased the odds of in-hospital mortality (aOR 3.48) compared to levels between 250-400 mmol/L in patients with infective endocarditis.
Why the study?
Increased uric acid levels are linked to poor outcomes in several conditions, but the prognostic value of uric acid in patients with infective endocarditis is unknown.
Does a U-shaped serum uric acid level (high or low) predict increased short-term mortality in adult patients with infective endocarditis?
Observational (n=1,117)
No
Does a U-shaped serum uric acid level (high or low) predict increased short-term mortality in adult patients with infective endocarditis?
Answers are grounded in this paper and cite their sources.
Both low (<250 μmol/L) and high (>400 μmol/L) serum uric acid levels are independent predictors of increased in-hospital and 6-month mortality in patients with infective endocarditis, exhibiting a U-shaped prognostic relationship.
Background: Increased uric acid (UA) levels have been reported to be associated with poor clinical outcomes in several conditions. However, the prognostic value of UA in patients with infective endocarditis (IE) is yet unknown. Methods: A total of 1,117 patients with IE were included and divided into two groups according to the current definition of hyperuricemia (UA>420 μmol/L in men and >360 μmol/L in women): hyperuricemia group (n=336) and normouricemia group (n=781). The association between the UA level and short-term outcomes were examined. Results: . 4.6%, p=0.001). Hyperuricemia was not an independent risk factor for in-hospital death (adjusted odds ratio [aOR]=1.92, 95% confidence interval [CI]: 0.92-4.02, p=0.084). A U-shaped relationship was found between the UA level and in-hospital death (p<0.001). The in-hospital mortality was lower in patients with UA in the range 250-400 μmol/L. The aOR of in-hospital death in patients with UA>400 and <250 μmol/L was 3.48 (95% CI: 1.38-8.80, p=0.008) and 3.28 (95%CI: 1.27-8.51, p=0.015), respectively. Furthermore, UA>400 μmol/L (adjusted hazard ratio [aHR]=3.54, 95%CI: 1.77-7.07, p<0.001) and <250 μmol/L (aHR=2.23, 95%CI: 1.03-4.80, p=0.041) were independent risk factors for the 6-month mortality. Conclusion: The previous definition of hyperuricemia was not suitable for risk assessment in patients with IE because of the U-shaped relationship between UA levels and in-hospital death. Low and high levels of UA were predictive of increased short-term mortality in IE patients.
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Wei et al. (2021) conducted an observational in Infective endocarditis (n=1,117). Serum uric acid >400 mmol/L vs. Serum uric acid 250-400 mmol/L was evaluated on In-hospital mortality (aOR 3.48, 95% CI 1.38-8.80, p=0.008). Serum uric acid levels >400 mmol/L increased the odds of in-hospital mortality (aOR 3.48) compared to levels between 250-400 mmol/L in patients with infective endocarditis.
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