The association of serum uric acid levels with coronary flow in patients with stemi undergoing primary pci
Özet
Objective: Uric acid has been shown as a predictor and an
independent risk factor for coronary heart disease, but little is
known regarding the association of uric acid levels with coronary
blood flow in STEMI. We hypothesized that elevated uric acid levels
would be associated with impaired flow and perfusion in the setting
of STEMI treated with primary PCI.
Methods: Two hundred and eighty nine patients with STEMI who
treated primary PCI were enrolled to study. Patients were divided
into two groups based upon the TIMI flow grade. No-reflow was
defined as TIMI Grade 0, 1 and 2 flows (Group 1). Angiographic
success was defined as TIMI 3 flow (Group 2). Uric acid and high
sensitive CRP were measured. Major adverse cardiac events (MACE)
were defined as in stent thrombosis, non-fatal myocardial infarction
and in-hospital mortality.
Results: There were 126 patients (mean age 63±11 and 71% male)
in group 1 and 163 patients (mean age 58±12 and 80% male) in
group 2. Uric acid, MPV, and CRP levels on admission were higher in
group 1 (p = 0.0001 for each). A uric acid level >5.3 mg/dl measured
on admission had a 77% sensitivity and 70% specificity in predicting
no reflow at ROC curves analysis. In-hospital MACE was significantly
higher in group 1 (29% vs. 7%, p = 0.0001). At multivariate analysis,
high plasma uric asid levels were independent predictors of MACE
[odds ratio (OR) 3.675, 95% CI 1.556–8.678; p = 0.003].
Conclusions: Plasma uric acid level on admission is a strong
and independent predictor of poor coronary blood flow following
primary PCI and in hospital MACE among patients with STEMI.
Except for predictive value, uric acid levels may be a useful
biomarker for stratification of risk in patients with STEMI and
may also lead to carry further therapeutic implications.
