Massimo Francesco Piepoli1, Elisabetta Salvioni2, Ugo Corrà3, Francesco Doni3, Alice Bonomi2, Rocco La Gioia4, Giuseppe Limongelli5, Stefania Paolillo6, Gianfranco Sinagra7, Angela B Scardovi8, Rosa Raimondo9, Michele Emdin10, Federica Re11, Mariantonietta Cicoira12, Michele Correale13, Roberto Badagliacca14, Francesco Clemenza15, Carlo Lombardi16, Piergiuseppe Agostoni17. 1. UOC Cardiologia, G da Saliceto Hospital, Piacenza, Italy; Department of Cardiology, University of Foggia, Foggia, Italy. 2. Centro Cardiologico Monzino, IRCCS, Milano, Italy. 3. Cardiology Department, Istituti Clinici Scientifici Maugeri, Veruno Institute, Veruno, Italy. 4. Division of Cardiology, "S. Maugeri" Foundation, IRCCS, Institute of Cassano Murge, Bari, Italy. 5. Cardiologia SUN, Ospedale Monaldi (Azienda dei Colli), Seconda Università di Napoli, Napoli, Italy. 6. Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy. 7. Cardiovascular Department, Ospedali Riuniti and University of Trieste, Trieste, Italy. 8. Cardiology Division, Santo Spirito Hospital, Roma, Italy. 9. Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Tradate, Italy. 10. Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa, Italy; Life Science Institute, Scuola Superiore Sant'Anna, Pisa, Italy. 11. Cardiology Division, Cardiac Arrhythmia Center and Cardiomyopathies Unit, San Camillo-Forlanini Hospital, Roma, Italy. 12. Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy. 13. Department of Cardiology, University of Foggia, Foggia, Italy. 14. Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, "Sapienza", Rome University, Rome, Italy. 15. Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS - ISMETT, Palermo, Italy. 16. Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. 17. Centro Cardiologico Monzino, IRCCS, Milano, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy. Electronic address: piergiuseppe.agostoni@unimi.it.
Abstract
BACKGROUND: Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results. OBJECTIVES: Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF. METHODS: An analysis of MECKI (Metabolic Exercise Cardiac Kidney Index) database, with median follow-up of 3.4 years. RESULTS: Relation between SUA and all-cause/ cardiovascular (CV) deaths have been analysed in 4,577 patients (3,688 males, age 62.7 ± 12.9 years), with reduced ejection fraction HF (35 ± 11%), peakVO2 1151 ± 440 ml/min; NYHA class I-II (72.6%), III-IV (27.4%). SUA was associated with increased total and CV mortality (HR 1.120 and HR 1.128, respectively p < 0.0001), also after adjustment for peakVO2, VE/VCO2 slope, diuretic use and MECKI score. SUA was significantly associated with CV mortality only in NYHA class I-II (HR 1.17, p < 0.0001) while there was no association in class III-IV (HR 1.03, p = NS). No prognostic added values of SUA with respect to the MECKI score was observed at the ROC analysis. CONCLUSIONS: SUA is confirmed to be associated with increased mortality, but in less severe HF only. However SUA did not show additional prognostic power to the MECKI score.
BACKGROUND:Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results. OBJECTIVES: Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF. METHODS: An analysis of MECKI (Metabolic Exercise Cardiac Kidney Index) database, with median follow-up of 3.4 years. RESULTS: Relation between SUA and all-cause/ cardiovascular (CV) deaths have been analysed in 4,577 patients (3,688 males, age 62.7 ± 12.9 years), with reduced ejection fraction HF (35 ± 11%), peakVO2 1151 ± 440 ml/min; NYHA class I-II (72.6%), III-IV (27.4%). SUA was associated with increased total and CV mortality (HR 1.120 and HR 1.128, respectively p < 0.0001), also after adjustment for peakVO2, VE/VCO2 slope, diuretic use and MECKI score. SUA was significantly associated with CV mortality only in NYHA class I-II (HR 1.17, p < 0.0001) while there was no association in class III-IV (HR 1.03, p = NS). No prognostic added values of SUA with respect to the MECKI score was observed at the ROC analysis. CONCLUSIONS: SUA is confirmed to be associated with increased mortality, but in less severe HF only. However SUA did not show additional prognostic power to the MECKI score.
Authors: Lina Miao; Ming Guo; Deng Pan; Pengfei Chen; Zhuhong Chen; Jie Gao; Yanqiao Yu; Dazhuo Shi; Jianpeng Du Journal: Front Med (Lausanne) Date: 2021-12-14
Authors: Ching-Lan Cheng; Chi-Tai Yen; Chien-Chou Su; Cheng-Han Lee; Chien-Huei Huang; Yea-Huei Kao Yang Journal: Front Cardiovasc Med Date: 2022-08-11