Serum uric acid is associated with mortality and heart failure hospitalizations in patients with complicated myocardial infarction: findings from the High‐Risk Myocardial Infarction Database Initiative
Identifieur interne : 000778 ( Main/Exploration ); précédent : 000777; suivant : 000779Serum uric acid is associated with mortality and heart failure hospitalizations in patients with complicated myocardial infarction: findings from the High‐Risk Myocardial Infarction Database Initiative
Auteurs : Thomas G. Von Lueder [Norvège] ; Nicolas Girerd [France] ; Dan Atar [Norvège] ; Stefan Agewall [Norvège] ; Zohra Lamiral [France] ; Mehmet Kanbay [Turquie] ; Bertram Pitt [États-Unis] ; Kenneth Dickstein [Norvège] ; Faiez Zannad [France] ; Patrick Rossignol [France]Source :
- European Journal of Heart Failure [ 1388-9842 ] ; 2015-11.
Abstract
Serum uric acid (SUA) levels are associated with poorer outcomes in healthy cohorts and patients with stable and unstable coronary heart disease. We investigated the relationship between SUA and clinical outcomes in subjects with acute myocardial infarction (MI) complicated by reduced left ventricular (LV) function, heart failure (HF), or both.
Univariable and multivariable Cox proportional hazards modelling was performed to study the association of baseline SUA and all‐cause mortality, cardiovascular (CV) mortality, and HF hospitalization in an individual patient meta‐analysis of four merged large randomized trials (CAPRICORN, EPHESUS, OPTIMAAL, and VALIANT). Three trials (excluding VALIANT) reported SUA, which was available in a total of 12 677 subjects. The ranges of SUA for quartiles I–IV were 45–280, 281–344, 345–420, and 420–1640 mmol/L, respectively. While almost 90% of patients in the lowest SUA quartile were alive after a mean follow‐up of 23 ± 11 months, <70% were alive in the highest SUA quartile. Compared with the lowest SUA quartile as reference, hazard ratios (HRs) and 95% confidence intervals (CIs) of SUA quartiles III and IV showed an increase in all‐cause mortality [HR 1.18, 95% CI 0.95–1.46, and HR 1.36, 95% CI 1.11–1.67) and CV mortality (HR 1.27, 95% 1.01–1.61, and HR 1.47, 95% CI 1.17–1.83). SUA quartiles III and IV also exhibited increased HF hospitalization (HR 1.22, 95% CI 1.09–1.36, and HR 1.28, 95% CI 1.14–1.43; P < 0.001 for all comparisons) in multivariable analyses. The addition of SUA was associated with a significant improvement in reclassification to predict CV mortality (net reclassification improvement 17.6%, 95% CI 14.9–20.5%, P < 0.001).
Elevated SUA is associated with poor outcomes in patients after MI complicated by reduced LV function, HF, or both. The quantification of SUA, a low‐cost routinely available biomarker, could improve risk stratification of patients with complicated MI.
Url:
DOI: 10.1002/ejhf.419
Affiliations:
- France, Norvège, Turquie, États-Unis
- Grand Est, Lorraine (région)
- Nancy, Vandœuvre-lès-Nancy
- Université de Lorraine
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sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>INSERM, Centre d'Investigations Cliniques‐1433, and INSERM U1116, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>CHU Nancy, Institut Lorrain du Cœur et des Vaisseaux, Vandoeuvre lès Nancy</wicri:regionArea><placeName><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Lorraine (région)</region><settlement type="city">Vandœuvre-lès-Nancy</settlement><settlement type="city" wicri:auto="agglo">Nancy</settlement></placeName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">France</country><wicri:regionArea>Université de Lorraine, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName><orgName type="university">Université de Lorraine</orgName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists) Network, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">European Journal of Heart Failure</title><title level="j" type="alt">EUROPEAN JOURNAL OF HEART FAILURE</title><idno type="ISSN">1388-9842</idno><idno type="eISSN">1879-0844</idno><imprint><biblScope unit="vol">17</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1144">1144</biblScope><biblScope unit="page" to="1151">1151</biblScope><biblScope unit="page-count">8</biblScope><publisher>John Wiley & Sons, Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2015-11">2015-11</date></imprint><idno type="ISSN">1388-9842</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1388-9842</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Serum uric acid (SUA) levels are associated with poorer outcomes in healthy cohorts and patients with stable and unstable coronary heart disease. We investigated the relationship between SUA and clinical outcomes in subjects with acute myocardial infarction (MI) complicated by reduced left ventricular (LV) function, heart failure (HF), or both.</div><div type="abstract">Univariable and multivariable Cox proportional hazards modelling was performed to study the association of baseline SUA and all‐cause mortality, cardiovascular (CV) mortality, and HF hospitalization in an individual patient meta‐analysis of four merged large randomized trials (CAPRICORN, EPHESUS, OPTIMAAL, and VALIANT). Three trials (excluding VALIANT) reported SUA, which was available in a total of 12 677 subjects. The ranges of SUA for quartiles I–IV were 45–280, 281–344, 345–420, and 420–1640 mmol/L, respectively. While almost 90% of patients in the lowest SUA quartile were alive after a mean follow‐up of 23 ± 11 months, <70% were alive in the highest SUA quartile. Compared with the lowest SUA quartile as reference, hazard ratios (HRs) and 95% confidence intervals (CIs) of SUA quartiles III and IV showed an increase in all‐cause mortality [HR 1.18, 95% CI 0.95–1.46, and HR 1.36, 95% CI 1.11–1.67) and CV mortality (HR 1.27, 95% 1.01–1.61, and HR 1.47, 95% CI 1.17–1.83). SUA quartiles III and IV also exhibited increased HF hospitalization (HR 1.22, 95% CI 1.09–1.36, and HR 1.28, 95% CI 1.14–1.43; P < 0.001 for all comparisons) in multivariable analyses. The addition of SUA was associated with a significant improvement in reclassification to predict CV mortality (net reclassification improvement 17.6%, 95% CI 14.9–20.5%, P < 0.001).</div><div type="abstract">Elevated SUA is associated with poor outcomes in patients after MI complicated by reduced LV function, HF, or both. The quantification of SUA, a low‐cost routinely available biomarker, could improve risk stratification of patients with complicated MI.</div></front></TEI><affiliations><list><country><li>France</li><li>Norvège</li><li>Turquie</li><li>États-Unis</li></country><region><li>Grand Est</li><li>Lorraine (région)</li></region><settlement><li>Nancy</li><li>Vandœuvre-lès-Nancy</li></settlement><orgName><li>Université de Lorraine</li></orgName></list><tree><country name="Norvège"><noRegion><name sortKey="Von Lueder, Thomas G" sort="Von Lueder, Thomas G" uniqKey="Von Lueder T" first="Thomas G." last="Von Lueder">Thomas G. Von Lueder</name></noRegion><name sortKey="Agewall, Stefan" sort="Agewall, Stefan" uniqKey="Agewall S" first="Stefan" last="Agewall">Stefan Agewall</name><name sortKey="Agewall, Stefan" sort="Agewall, Stefan" uniqKey="Agewall S" first="Stefan" last="Agewall">Stefan Agewall</name><name sortKey="Atar, Dan" sort="Atar, Dan" uniqKey="Atar D" first="Dan" last="Atar">Dan Atar</name><name sortKey="Atar, Dan" sort="Atar, Dan" uniqKey="Atar D" first="Dan" last="Atar">Dan Atar</name><name sortKey="Dickstein, Kenneth" sort="Dickstein, Kenneth" uniqKey="Dickstein K" first="Kenneth" last="Dickstein">Kenneth Dickstein</name><name sortKey="Von Lueder, Thomas G" sort="Von Lueder, Thomas G" uniqKey="Von Lueder T" first="Thomas G." last="Von Lueder">Thomas G. Von Lueder</name></country><country name="France"><region name="Grand Est"><name sortKey="Girerd, Nicolas" sort="Girerd, Nicolas" uniqKey="Girerd N" first="Nicolas" last="Girerd">Nicolas Girerd</name></region><name sortKey="Girerd, Nicolas" sort="Girerd, Nicolas" uniqKey="Girerd N" first="Nicolas" last="Girerd">Nicolas Girerd</name><name sortKey="Girerd, Nicolas" sort="Girerd, Nicolas" uniqKey="Girerd N" first="Nicolas" last="Girerd">Nicolas Girerd</name><name sortKey="Girerd, Nicolas" sort="Girerd, Nicolas" uniqKey="Girerd N" first="Nicolas" last="Girerd">Nicolas Girerd</name><name sortKey="Lamiral, Zohra" sort="Lamiral, Zohra" uniqKey="Lamiral Z" first="Zohra" last="Lamiral">Zohra Lamiral</name><name sortKey="Lamiral, Zohra" sort="Lamiral, Zohra" uniqKey="Lamiral Z" first="Zohra" last="Lamiral">Zohra Lamiral</name><name sortKey="Lamiral, Zohra" sort="Lamiral, Zohra" uniqKey="Lamiral Z" first="Zohra" last="Lamiral">Zohra Lamiral</name><name sortKey="Lamiral, Zohra" sort="Lamiral, Zohra" uniqKey="Lamiral Z" first="Zohra" last="Lamiral">Zohra Lamiral</name><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name><name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name><name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name><name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name><name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name></country><country name="Turquie"><noRegion><name sortKey="Kanbay, Mehmet" sort="Kanbay, Mehmet" uniqKey="Kanbay M" first="Mehmet" last="Kanbay">Mehmet Kanbay</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Pitt, Bertram" sort="Pitt, Bertram" uniqKey="Pitt B" first="Bertram" last="Pitt">Bertram Pitt</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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