Prognostic Value of Uric Acid for Pulmonary Thromboembolism

Abstract

Background: Pulmonary thromboembolism is a serious cardiovascular condition with considerable morbidity and mortality. Clinical studies have indicated that hyperuricemia is an independent risk factor for cardiovascular events. The aim of this study was to investigate possible value of the serum levels of uric acid (UA) in predicting 30-d pulmonary thromboembolism-related mortality.

Methods: Pulmonary thromboembolism was confirmed by computed tomography pulmonary angiography, demographic data, troponin, systolic pressure and pulse on admission, and simplified pulmonary embolism severity index assessment. UA levels were analyzed on admission. The primary end point was all-cause mortality during the first 30 d.

Results: A total of 337 acute pulmonary thromboembolism subjects, of whom 59% were females, were enrolled. The median (interquartile range) serum UA level was 5.35 (4.1-7.3) mg/dL. Serum UA levels of deceased subjects were higher than those of alive subjects during the study period (6.9 [4.6-10.0] mg/dL vs 5.2 [4.1-7.0] mg/dL, P = .038). In the receiver operating characteristic analysis, the area under the curve was 0.650 (CI 0.732-0.960) for UA levels for all-cause mortality. A level of serum UA ≥ 5 mg/dL showed 73% sensitivity and 88% negative predictive value for all-cause 30-d mortality. A weak correlation was determined between the UA levels and age (r = 0.25, P < .001) and any troponin (r = 0.267, P < .001). Serum UA level was an independent predictor of short-term mortality in pulmonary thromboembolism (odds ratio 1.2, P = .002).

Conclusions: Serum UA levels may be a potential biomarker for predicting outcome in patients with acute pulmonary thromboembolism.

Keywords: prognosis; pulmonary embolism; uric acid.