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Hyperuricemia Predicts Cardiac Risk in Surgical Patients

Late mortality and major adverse cardiac events predicted by perioperative uric acid levels

TUESDAY, Sept. 30 (HealthDay News) -- Hyperuricemia in patients undergoing vascular surgery is predictive of late mortality and major adverse cardiac events, but not 30-day mortality, researchers report in the Oct. 1 issue of the American Journal of Cardiology.

Martin Dunkelgrun, M.D., of the Erasmus Medical Centre in Rotterdam, the Netherlands, and colleagues examined the relationship between preoperative serum uric acid levels and mortality among patients scheduled for open vascular surgery. Adjusted multivariable logistic and Cox regression analysis were performed using risk of 30-day mortality, late mortality and major adverse cardiac events as the main outcome measures.

The investigators found that of the 936 enrolled patients, 299 (32 percent) had hyperuricemia (serum uric acid over 0.42 mmol/L for men and over 0.36 mmol/L for women). In the perioperative period, 46 patients (5 percent) died and 61 (7 percent) experienced a major adverse cardiac event. During a mean follow-up of 3.7 years, 30 percent died and 18 percent experienced a major adverse cardiac event, the researchers report. While patients with hyperuricemia were more commonly diagnosed with heart failure, chronic kidney disease and used diuretics, hyperuricemia was not significantly correlated with an increased 30-day mortality or major adverse cardiac event in adjusted analyses. However, hyperuricemia increased odds of late mortality and major adverse cardiac events (hazard ratios 1.4 and 1.7, respectively).

"Although it is not possible to conclude that hyperuricemia is a causal risk factor because of the observational nature of this study, these results indicate a clinical importance of monitoring hyperuricemia in patients scheduled for vascular surgery because these patients are at increased risk for coronary heart disease," the authors write.

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