Key result
Elevated serum uric acid was not associated with an increased risk of major cardiovascular events, despite being associated with high-risk coronary plaque features.
Why the study?
The interaction of serum uric acid with atherogenesis and its association with coronary plaque composition and major adverse cardiac events is incompletely understood.
Does elevated serum uric acid predict major adverse cardiac events and high-risk coronary plaque features in patients undergoing coronary CTA?
Cohort (n=1,242)
Does elevated serum uric acid predict major adverse cardiac events and high-risk coronary plaque features in patients undergoing coronary CTA?
Answers are grounded in this paper and cite their sources.
While elevated serum uric acid is associated with high-risk coronary plaque features on CTA, it does not independently predict major adverse cardiac events over long-term follow-up.
BACKGROUND AND AIMS: The interaction of serum uric acid (SUA) with atherogenesis is incompletely understood. Aim of our study was to investigate the association of SUA levels with coronary plaque composition including high-risk-plaque (HRP) features by coronary computed tomography angiography (CTA) and for the prediction of major adverse cardiac events (MACE). METHODS AND RESULTS: 1242 patients (age 66.17 ± 11.03; 56 % males) referred to coronary CTA were included. SUA>6.5 mg/dl was defined as hyperuricemia. CTA-image analysis included: Coronary stenosis severity (CADRADS), plaque burden (SIS/G-score weighted for non-calcifying plaque), plaques types (1 = calcifying; 2 = mixed (predominantly calcifying); 3 = mixed (predominantly noncalcifying), 4 = noncalcifying."High-risk-plaque"(HRP)-features were quantified: Low-attenuation plaque (LAP) density, Spotty calcification, Napkin-Ring Sign (NRS), Remodeling Index. Coronary Artery Calcium Score (CAC) was measured. Primary outcome was MACE. HRP-features were more prevalent in patients with hyperuricemia (p = 0.005, p = 0.0002, p = 0.0004). SUA level was associated with LAP<30HU (HR:1.23; p = 0.04). Plaque burden and CAC-score were higher in the hyperuricemia group (G-score:p = 0.022 and CAC:p = 0.027). After a mean follow-up of mean 8,32 years, MACE rate was 2.9 %. There was no difference in the MACE rate between subjects with elevated SUA and normals (HR 1.221:95%CI:0.817-2.563; p = 0.597). Low-attenuation-plaque density/LAP<30HU was the strongest prognosticator for MACE (p = 0.033 and p = 0.013); stenosis severity, plaque types and G-score were also predictive, but not SUA, CAC and the other conventional cardiovascular risk factors (except smoking). CONCLUSION: SUA is associated with HRP-features and coronary plaque burden. Low attenuation plaque is the strongest predictor of MACE, but not SUA level and other major CVRF. CTA imaging biomarkers may improve CV-risk stratification in patients with hyperuricemia.
No takes yet. Share an insight, caveat, or question.
Lacaita et al. (2024) conducted a cohort in Coronary atherosclerosis (n=1,242). Hyperuricemia (serum uric acid > 6.5 mg/dl) vs. Normal serum uric acid was evaluated on Major adverse cardiac events (MACE) (HR 1.221, 95% CI 0.817-2.563, p=0.597). Elevated serum uric acid was not associated with an increased risk of major cardiovascular events, despite being associated with high-risk coronary plaque features.
Synapse has enriched 10 related papers. Consider them for comparative context: