Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Determinants and Prognostic Impact of Hyperuricemia in Hospitalization for Acute Heart Failure
Wei-Ming HuangPai-Feng HsuHao-Min ChengDai-Yin LuYu-Lun ChengChao-Yu GuoShih-Hsien SungWen-Chung YuChen-Huan Chen
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2016 Volume 80 Issue 2 Pages 404-410

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Abstract

Background:Hyperuricemia is a prognostic factor in patients with chronic heart failure, but whether uric acid level can predict clinical outcome of acute heart failure (AHF) remains to be elucidated. We therefore investigated the association of uric acid with mortality in patients hospitalized for AHF.Methods and Results:Data for patients hospitalized for AHF were drawn from an intramural registry. Biochemistry data, echocardiographic characteristics, and uric acid level were collected. National Death Registry was linked for the identification of mortality data. Among a total of 1,835 participants (age, 75±13 years, 68% men), 794 patients died during follow-up. Patients who died were older, had lower hemoglobin and estimated glomerular filtration rate, and higher pulmonary artery systolic pressure, NT-proBNP, and uric acid. Uric acid was a significant predictor of mortality on univariate analysis (HR per 1 SD, 1.18; 95% CI: 1.11–1.26) and in multivariate Cox models (HR, 1.15; 95% CI: 1.02–1.29). Survival analysis showed an increasing risk of death along the quartile distribution of uric acid level. Given renal function, cardiac performance, and kidney perfusion as major determinants of hyperuricemia, the prognostic impact of uric acid level was diminished as renal function deteriorated.Conclusions:Uric acid level was an independent predictor of mortality in patients hospitalized for AHF, but the prognostic impact of hyperuricemia was attenuated by worsening renal function. (Circ J 2016; 80: 404–410)

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© 2016 THE JAPANESE CIRCULATION SOCIETY
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