The association of serum uric acid and 1-year major adverse cardiovascular events in patients undergoing percutaneous coronary intervention

Context: Elevated uric acid (UA) is seen in several vascular diseases. Its significance as a prognostic marker in patients undergoing percutaneous coronary intervention (PCI) is unknown. Aims: The aim of this study was to evaluate the association between elevated UA and major adverse cardiovascular events (MACE) at 1 year in patients undergoing PCI. Settings and Design: This was a prospective, observational, single-center study. Subjects and Methods: Patients undergoing PCI were categorized into hyperuricemic (HU, UA >6.0 mg/dl in women and >7.0 mg/dl in men) and normouricemic (NU) groups and were observed for 1 year. The endpoint was difference in MACE (composite of deaths, nonfatal myocardial infarction, stroke, and target vessel revascularization) at 1 year between the two groups. The secondary endpoints were the difference in Killip class at presentation, angiographic severity of coronary artery disease (CAD), cardiac arrhythmias, and congestive heart failure (CHF) between the two groups. Results: A total of 215 patients (107 in HU arm and 108 in NU arm) were recruited. Patients in the HU arm were older, had higher frequency of multivessel CAD (93.5% vs. 79.6%, P < 0.05) and complex coronary lesions (98.1% vs. 91.7%, P < 0.05). MACE at 1 year were more frequent in the HU arm compared to the NU arm (21.5% vs. 6.5%, P < 0.05). New-onset atrial fibrillation (AF) (11.2% vs. 3.7%, P < 0.05) and CHF (13.1% vs. 4.6%, P < 0.05) were also more frequent in the HU arm versus the NU arm. Conclusions: Elevated serum UA level in patients undergoing PCI was associated with angiographically more severe and multivessel CAD, a higher frequency of MACE, CHF, new-onset AF, and a higher mortality than those having normal UA levels.