Key result
Hyperuricemia linked to ~47% higher post-PCI MACE risk exclusively in patients receiving diuretics.
Why the study?
Thiazide and loop diuretics elevate serum uric acid levels, and whether the prognostic significance of hyperuricemia differs according to diuretic use in patients with CAD undergoing PCI remained unclear.
Cohort (n=9,098)
Yes
Diuretic use may modify hyperuricemia's MACE association post-PCI; hypothesis-generating and leaves open whether management should differ by diuretic status.
Background: Hyperuricemia has been linked to adverse cardiovascular outcomes. Thiazide and loop diuretics are known to elevate serum uric acid (SUA) levels; however, whether the prognostic significance of hyperuricemia differs according to diuretic use in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear.
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Akashi et al. (2026) conducted a cohort in Coronary artery disease undergoing percutaneous coronary intervention (n=9,098). Hyperuricemia among oral diuretic users vs. Non-hyperuricemia among oral diuretic users was evaluated on Major adverse cardiac events (MACE), a composite of cardiovascular death, myocardial infarction, and hospitalization for heart failure (HR 1.47, 95% CI 1.14-1.89, p=0.003). Hyperuricemia was independently associated with a higher risk of MACE in CAD patients after PCI receiving diuretics (HR 1.47, 95% CI 1.14–1.89; P=0.003), but not in non-users (HR 1.08).
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