TY - JOUR
T1 - Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group
AU - Piepoli, Massimo Francesco
AU - Salvioni, Elisabetta
AU - Corrà, Ugo
AU - Doni, Francesco
AU - Bonomi, Alice
AU - La Gioia, Rocco
AU - Limongelli, Giuseppe
AU - Paolillo, Stefania
AU - Sinagra, Gianfranco
AU - Scardovi, Angela B
AU - Raimondo, Rosa
AU - Emdin, Michele
AU - Re, Federica
AU - Cicoira, Mariantonietta
AU - Correale, Michele
AU - Badagliacca, Roberto
AU - Clemenza, Francesco
AU - Lombardi, Carlo
AU - Agostoni, Piergiuseppe
N1 - Copyright © 2019. Published by Elsevier B.V.
PY - 2019/11/7
Y1 - 2019/11/7
N2 - BACKGROUND: Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results.OBJECTIVES: Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF.METHODS: An analysis of MECKI (Metabolic Exercise Cardiac Kidney Index) database, with median follow-up of 3.4 years.RESULTS: Relation between SUA and all-cause/ cardiovascular (CV) deaths have been analysed in 4,577 patients (3,688 males, age 62.7 ± 12.9 years), with reduced ejection fraction HF (35 ± 11%), peakVO2 1151 ± 440 ml/min; NYHA class I-II (72.6%), III-IV (27.4%). SUA was associated with increased total and CV mortality (HR 1.120 and HR 1.128, respectively p < 0.0001), also after adjustment for peakVO2, VE/VCO2 slope, diuretic use and MECKI score. SUA was significantly associated with CV mortality only in NYHA class I-II (HR 1.17, p < 0.0001) while there was no association in class III-IV (HR 1.03, p = NS). No prognostic added values of SUA with respect to the MECKI score was observed at the ROC analysis.CONCLUSIONS: SUA is confirmed to be associated with increased mortality, but in less severe HF only. However SUA did not show additional prognostic power to the MECKI score.
AB - BACKGROUND: Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results.OBJECTIVES: Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF.METHODS: An analysis of MECKI (Metabolic Exercise Cardiac Kidney Index) database, with median follow-up of 3.4 years.RESULTS: Relation between SUA and all-cause/ cardiovascular (CV) deaths have been analysed in 4,577 patients (3,688 males, age 62.7 ± 12.9 years), with reduced ejection fraction HF (35 ± 11%), peakVO2 1151 ± 440 ml/min; NYHA class I-II (72.6%), III-IV (27.4%). SUA was associated with increased total and CV mortality (HR 1.120 and HR 1.128, respectively p < 0.0001), also after adjustment for peakVO2, VE/VCO2 slope, diuretic use and MECKI score. SUA was significantly associated with CV mortality only in NYHA class I-II (HR 1.17, p < 0.0001) while there was no association in class III-IV (HR 1.03, p = NS). No prognostic added values of SUA with respect to the MECKI score was observed at the ROC analysis.CONCLUSIONS: SUA is confirmed to be associated with increased mortality, but in less severe HF only. However SUA did not show additional prognostic power to the MECKI score.
U2 - 10.1016/j.ejim.2019.11.003
DO - 10.1016/j.ejim.2019.11.003
M3 - Article
C2 - 31787490
SN - 0953-6205
VL - 72
SP - 47
EP - 52
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -