Serum uric acid level predicts mortality in coronary artery disease

Ioachimescu AG, Brennan DM, Hoar BM, et al, Cleveland Clinic, Ohio. Serum uric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease: a preventive cardiology information system (PreCIS) database cohot study. Arthritis Rheum. 2008;58:623-630.

The serum uric acid level is an independent predictor of mortality in patients at high risk for coronary artery disease (CAD). Routine measurement of serum uric acid levels may be useful because it contributes to risk stratification beyond the scores currently used.

Ioachimescu and colleagues conducted a retrospective review of 3098 patients with CAD. Serum uric acid levels were determined in all patients, and all data (eg, medical history, physical examination, and laboratory) were entered into a database. Patients' vital status was updated monthly, and mortality rates were calculated.

During follow-up (14,262 person-years), 5% of patients died. Uric acid levels were significantly higher in subjects who died than in those who survived. Mortality rates during follow-up were higher in patients taking diuretics and in those taking thiazides at baseline than in those who were not. The serum uric acid level remained a predictor of death from all causes after adjustment for age; sex; history of diabetes mellitus, CAD, stroke, or hypertension; smoking status; and other factors.

The authors noted that further analyses are needed to clarify whether therapies that lower serum uric acid levels may benefit patients at high risk for cardiovascular events.