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Meta-Analysis
. 2019 Oct 15;19(1):218.
doi: 10.1186/s12872-019-1215-z.

Serum uric acid and risk of cardiovascular mortality: a systematic review and dose-response meta-analysis of cohort studies of over a million participants

Fatemeh Rahimi-Sakak  1 , Mahsa Maroofi  1 , Jamal Rahmani  1 , Nick Bellissimo  2 , Azita Hekmatdoost  3
Affiliations
Meta-Analysis

Serum uric acid and risk of cardiovascular mortality: a systematic review and dose-response meta-analysis of cohort studies of over a million participants

Fatemeh Rahimi-Sakak et al. BMC Cardiovasc Disord. .

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Some studies have suggested anassociation between serum uric acid levels and cardiovascular mortality; however, the results have not been summarized in a meta-analysis.

Methods: A comprehensive search of all related studies until April 2018was performed in MEDLINE/PubMed and Scopus databases DerSimonianand Laird random-effects models were used to combine hazard ratios (HRs) with 95% confidence intervals (CIs). Dose-response analysis was also carried out.

Results: Thirty-two studies containing forty-four arms with 1,134,073 participants reported association between uric acid and risk of CVD mortality were included in our analysis. Pooled results showed a significant positive association between uric acid levels and risk of CVD mortality (HR 1.45, 95% CI 1.33-1.58, I2 = 79%). Sub-group analysis showed this relationshipwasstronger in women compared to men. Moreover, there was a significant non-linear association between uric acid levels and the risk of CVD mortality (r = 0.0709, p = 0.001).

Conclusion: Our analysis indicates a positive dose-response association between SUA and CVD mortality risk.

Keywords: CVD mortality; Cardiovascular diseases mortality; Cohort; Longitudinal; Serum uric acid; Uric acid.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of studies reviewed
Fig. 2
Fig. 2
The forest plot between highest versus lowest categories of serum uric acid and cardiovascular disease mortality
Fig. 3
Fig. 3
The forest plot between highest versus lowest categories of serum uric acid and cardiovascular disease mortality based on gender
Fig. 4
Fig. 4
Dose-response association between serum uric acid (mg/dL) and cardiovascular disease mortality (HR)
Fig. 5
Fig. 5
Funnel plots to assessment publication bias
See this image and copyright information in PMC

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