Serum Uric Acid as an Independent and Incremental Prognostic Marker in Addition to N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Acute Myocardial Infarction

BACKGROUND: There are limited data regarding the prognostic value of serum uric acid (UA) after acute myocardial infarction (AMI). We investigated whether UA predicts the prognosis independently and whether it has an incremental value to other factors, including N-terminal Pro-B-type natriuretic peptide (NT-ProBNP), in patients with AMI. METHODS AND RESULTS: This study included 850 patients with AMI who were enrolled in the Korea AMI Registry from a single center. A major adverse cardiovascular event (MACE) was defined as a composite of death, recurrent myocardial infarction, and revascularization. During 6-month follow-up, MACE developed in 109 (12.8%). UA was higher in patients with MACE than in those without MACE (6.5 ± 2.4 mg/dl vs. 5.4 ± 1.8 mg/dl, P < 0.001). In the Cox-proportional hazard model, UA (hazard ratio [HR] 1.297, 95% confidence interval [CI] 1.075-1.565, P=0.007) was an independent predictor for 6-month MACE in addition to log NT-ProBNP (HR 2.362, 95%CI 1.007-5.539, P = 0.048), heart rate (HR 1.028, 95%CI 1.009-1.047, P = 0.004) and 3-vessel disease (HR 3.278, 95%CI 1.378 to 7.797, P = 0.007). UA had incremental prognostic value to conventional risk factors (chi-squar e= 8, P = 0.005), and to the combination of conventional factors and NT-ProBNP (chi-square = 10, P = 0.002). CONCLUSIONS: UA is an independent predictor of short-term prognosis and has incremental value to NT-ProBNP in patients with AMI.