Key result
Both low (<250 µmol/L) and high (≥450 µmol/L) serum uric acid concentrations increased all-cause mortality risk compared to 250-350 µmol/L (HR 2.52, P=0.024 and HR 2.73, P=0.003, respectively).
Why the study?
No study had examined the effect of low serum uric acid concentrations on mortality in hypertrophic cardiomyopathy patients.
Is there a U-shaped association between serum uric acid concentration and mortality in patients with hypertrophic cardiomyopathy?
Cohort (n=454)
Is there a U-shaped association between serum uric acid concentration and mortality in patients with hypertrophic cardiomyopathy?
Hazard Ratio: 2.52 (95% CI 1.13–5.61)
p-value: p=0.024
There is a U-shaped association between serum uric acid concentrations and both all-cause and HCM-related mortality in patients with hypertrophic cardiomyopathy.
U-shaped uric acid-mortality link in HCM is hypothesis-generating; prospective trials needed before any monitoring or intervention changes.
Background. No study has examined the effect of low serum uric acid (SUA) concentrations on mortality in hypertrophic cardiomyopathy (HCM) patients. The aim of the present study was to assess the relations between both low and high SUA concentrations and the risk of mortality across the full range of SUA concentrations in a retrospective cohort of HCM patients. Methods. A total of 454 HCM patients were enrolled in the study, and SUA concentrations were measured at baseline. The primary and secondary endpoints were all-cause mortality and HCM-related mortality, respectively. The associations between SUA concentrations and endpoints were analysed. Results. During a median follow-up of 3.8 years, there were 80 (17.6%) all-cause mortality events, and 52 of them (11.5%) were ascribed to HCM-related mortality. Patients with SUA concentrations of 250–350 µmol/L had the lowest all-cause mortality rate (11.8%) and HCM-related mortality rate (5.0%). Both low and high SUA concentrations were associated with increased all-cause and HCM-related mortality. Adjusted HRs were 2.52 (95% CI 1.13–5.61, p = 0.024) and 4.86 (95% CI 1.74–13.58, p = 0.003) for all-cause mortality and HCM-related mortality in the lowest SUA group (<250 µmol/L) when compared with the reference group (250–350 µmol/L), respectively. The corresponding HRs in the highest SUA group (≥450 µmol/L) were 2.73 (95% CI 1.42–5.23, p = 0.003) and 4.14 (95% CI 1.70–10.13, p = 0.002), respectively. Conclusions. Both low and high SUA concentrations were significantly associated with increased risk of all-cause mortality and HCM-related mortality, which supported a U-shaped association between SUA concentrations and mortality in HCM patients.
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Wang et al. (2020) conducted a cohort in hypertrophic cardiomyopathy (n=454). Low (<250 µmol/L) and high (≥450 µmol/L) serum uric acid concentrations vs. Serum uric acid concentrations of 250–350 µmol/L was evaluated on all-cause mortality (HR 2.52, 95% CI 1.13-5.61, p=0.024). Both low (<250 µmol/L) and high (≥450 µmol/L) serum uric acid concentrations increased all-cause mortality risk compared to 250-350 µmol/L (HR 2.52, P=0.024 and HR 2.73, P=0.003, respectively).
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