Xue-Biao Wei1, Lei Jiang1, Yuan-Hui Liu1, Du Feng2, Peng-Cheng He1, Jiyan Chen1, Dan-Qing Yu3, Ning Tan4. 1. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China. 2. The Department of Developmental Biology, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, United States. 3. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China. Electronic address: gdydq100@126.com. 4. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China. Electronic address: ningtan888@yeah.net.
Abstract
BACKGROUND: We evaluated the relationship between admission serum uric acid (SUA) and in-hospital and one-year mortality after valve replacement surgery (VRS) for patients with rheumatic heart disease (RHD). METHODS: One-thousand five-hundred thirty-six consecutive patients with RHD undergoing VRS were divided into 4 groups based on the quartiles of SUA on admission. The association between SUA and adverse outcomes was analyzed. RESULTS: The in-hospital mortality (2.1% vs 2.6% vs 5.3% vs 7.7%, p<0.001) and postoperative acute kidney injury (AKI) (52.0% vs 52.6% vs 61.6% vs 63.3%, p=0.001) increased from the lowest to the highest SUA quartiles. SUA levels were negatively correlated with eGFR value (r=-0.426, p<0.001) and positively correlated with C-reactive protein value (r=0.103, p<0.001). ROC analysis showed that SUA had good predictive value for in-hospital death (AUC=0.665, p<0.001) and was similar to Euro score (Z=0.966, p=0.334). Multiple logistic regression analysis showed that SUA was independently associated with in-hospital (OR=1.21, 95% CI: 1.06, 1.37, p=0.004) and one-year mortality (HR=1.17, 95% CI: 1.05, 1.29, p=0.003). Kaplan-Meier analysis demonstrated that the cumulative rate of one-year mortality after surgery was higher in patients with SUA>7.3mg/dl (Log-rank=21.1, p<0.001). CONCLUSIONS: Admission SUA could be used as a preoperative risk assessment factor in RHD patients who underwent VRS.
BACKGROUND: We evaluated the relationship between admission serum uric acid (SUA) and in-hospital and one-year mortality after valve replacement surgery (VRS) for patients with rheumatic heart disease (RHD). METHODS: One-thousand five-hundred thirty-six consecutive patients with RHD undergoing VRS were divided into 4 groups based on the quartiles of SUA on admission. The association between SUA and adverse outcomes was analyzed. RESULTS: The in-hospital mortality (2.1% vs 2.6% vs 5.3% vs 7.7%, p<0.001) and postoperative acute kidney injury (AKI) (52.0% vs 52.6% vs 61.6% vs 63.3%, p=0.001) increased from the lowest to the highest SUA quartiles. SUA levels were negatively correlated with eGFR value (r=-0.426, p<0.001) and positively correlated with C-reactive protein value (r=0.103, p<0.001). ROC analysis showed that SUA had good predictive value for in-hospital death (AUC=0.665, p<0.001) and was similar to Euro score (Z=0.966, p=0.334). Multiple logistic regression analysis showed that SUA was independently associated with in-hospital (OR=1.21, 95% CI: 1.06, 1.37, p=0.004) and one-year mortality (HR=1.17, 95% CI: 1.05, 1.29, p=0.003). Kaplan-Meier analysis demonstrated that the cumulative rate of one-year mortality after surgery was higher in patients with SUA>7.3mg/dl (Log-rank=21.1, p<0.001). CONCLUSIONS: Admission SUA could be used as a preoperative risk assessment factor in RHD patients who underwent VRS.