Key result
Elevated serum uric acid is linked to ~38% higher risk of fatal MI.
Why the study?
Prognostic cut-off values of serum uric acid for predicting fatal myocardial infarction in women and men were not established.
Does elevated serum uric acid predict fatal myocardial infarction in men and women?
Cohort (n=23,467)
Yes
Does elevated serum uric acid predict fatal myocardial infarction in men and women?
Elevated serum uric acid is an independent risk factor for fatal myocardial infarction, particularly in women, with a prognostic cut-off of >5.26 mg/dl.
Supports uric acid as prognostic marker for fatal MI in women; leaves open whether lowering it reduces events.
OBJECTIVE: The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension conceived and designed an ad-hoc study aimed at searching for prognostic cut-off values of serum uric acid (SUA) in predicting fatal myocardial infaction (MI) in women and men. METHODS: The URic acid Right for heArt Health study is a nationwide, multicentre, observational cohort study involving data on individuals aged 18-95 years recruited on a regional community basis from all the territory of Italy under the patronage of the Italian Society of Hypertension with a mean follow-up period of 122.3 ± 66.9 months. RESULTS: A total of 23 467 individuals were included in the analysis. Cut-off values of SUA able to discriminate MI status were identified by mean of receiver operating characteristic curves in the whole database (>5.70 mg/dl), in women (>5.26 mg/dl) and in men (>5.49 mg/dl). Multivariate Cox regression analyses adjusted for confounders (age, arterial hypertension, diabetes, chronic kidney disease, smoking habit, ethanol intake, BMI, haematocrit, LDL cholesterol and use of diuretics) identified an independent association between SUA and fatal MI in the whole database (hazard ratio 1.381, 95% confidence intervals, 1.096-1.758, P = 0.006) and in women (hazard ratio 1.514, confidence intervals 1.105-2.075, P < 0.01), but not in men. CONCLUSION: The results of the current study confirm that SUA is an independent risk factor for fatal MI after adjusting for potential confounding variables, and demonstrate that a prognostic cut-off value associated to fatal MI can be identified at least in women.
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Casiglia et al. (2019) conducted a cohort in Fatal myocardial infarction (n=23,467). Serum uric acid > 5.70 mg/dl vs. Serum uric acid ≤ 5.70 mg/dl was evaluated on Fatal myocardial infarction (HR 1.381, 95% CI 1.096-1.758, p=0.006). Serum uric acid >5.70 mg/dl was independently associated with an increased risk of fatal myocardial infarction (HR 1.381), with a specific prognostic cut-off of >5.26 mg/dl identified in women.
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