Hyperuricemia on Admission Predicts Short-Term Mortality due to Myocardial Infarction in a Population with High Prevalence of Cardiovascular Risk Factors

Abstract

Background: National health surveys have revealed an outstandingly high prevalence of obesity, hypertension, and diabetes in Mexico.

Objective: To assess whether serum uric acid levels on admission may predict short-term mortality in patients with ST-segment elevation myocardial infarction in a population with an unusually high prevalence of classic cardiovascular risks.

Methods: A total of 795 ST-segment elevation myocardial infarction patients undergoing primary reperfusion therapy were classified as having normouricemia or hyperuricemia according to serum uric acid levels at admission, and the occurrence of mortality and major adverse cardiovascular events during coronary care unit stay was assessed.

Results: Patients with hyperuricemia (n = 291; mean age 61.2 ± 11.9 years; 74.8% males) were older, obese, hypertensive, and had a higher Killip class at admission than those with normouricemia (n = 504; mean age 57.6 ± 11.3 years; 88.9% males). Mortality rates were 1.7 and 0.7 cases/100 patients per day of coronary care unit stay in hyperuricemic and normouricemic patients, respectively. Comparatively, no association was observed for the occurrence of major adverse cardiovascular events. After multivariate adjustments, independent predictors for short-term mortality were only Killip class ≥ 2 (HR: 13.15; 95% CI: 5.29-29.85; p < 0.0001) and elevated serum uric acid levels (HR: 1.99; 95% CI: 1.08-3.66; p = 0.026).

Conclusions: Hyperuricemia on admission remains associated with short-term mortality in ST-segment elevation myocardial infarction patients from a population with an unusually high prevalence of cardiovascular risk factors.