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Prognostic value of serum uric acid levels in patients with non-STEMI undergoing percutaneous coronary intervention

Prognostischer Wert der Serumharnsäurewerte bei Patienten mit NSTEMI und perkutaner Koronarintervention

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Abstract

Background

Because myocardial infarction in young adults is rare, there has been limited research on the condition in this patient group. Very few data are available regarding the long-term outcomes of patients under 40 years of age with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing invasive treatments. The prognostic value of uric acid (UA) in young patients with NSTEMI who undergo percutaneous coronary intervention (PCI) has also not been studied. The purpose of this study was to evaluate the long-term clinical outcomes of this specific subset of young patients. In addition, we aimed to identify the role of serum UA in predicting the long-term prognosis of young patients with NSTEMI who have undergone PCI.

Methods

We performed a retrospective analysis of 213 young adult patients (≤40 years old) with NSTEMI who underwent PCI during their hospitalization at our tertiary referral center.

Results

The mean age of the 213 patients was 36.8 ± 3.3 years (range, 21–40 years). The median follow-up was 930 days. Our patients were predominantly male (88.3%) and the most frequent traditional cardiovascular risk factors were smoking and dyslipidemia. Baseline TIMI flow 0–1, estimated glomerular filtration rate (eGFR), and UA were found to be independently correlated with long-term major adverse cardiovascular events (MACEs) in multivariate Cox regression analysis.

Conclusion

In the present study, baseline TIMI flow 0–1, admission eGFR, and UA levels were correlated with MACEs during long-term follow-up in young patients with NSTEMI.

Zusammenfassung

Hintergrund

Da ein Herzinfarkt bei jungen Erwachsenen selten ist, gibt es Untersuchungen dazu in dieser Patientengruppe nur in begrenztem Umfang. Zu den Langzeitergebnissen von Patienten unter 40 Jahren mit Nicht-ST-Strecken-Hebungs-Infarkt (NSTEMI), bei denen eine invasive Therapie durchgeführt wurde, gibt es nur sehr wenige Daten. Der prognostische Wert der Harnsäurewerte bei jungen Patienten mit NSTEMI, bei denen eine perkutane Koronarintervention (PCI) erfolgt, ist bisher ebenfalls nicht untersucht worden. Ziel der vorliegenden Studie war es, die klinischen Langzeitergebnisse dieser speziellen Untergruppe junger Patienten zu untersuchen. Darüber hinaus war es Ziel der Autoren, die Bedeutung der Harnsäure im Serum für die Vorhersage der Langzeitprognose junger Patienten mit NSTEMI zu ermitteln, bei denen eine PCI durchgeführt wurde.

Methoden

Retrospektiv wurden die Daten von 213 jungen erwachsenen Patienten (≤40 Jahre) mit NSTEMI ausgewertet, bei denen während ihres stationären Aufenthalts in dem Tertiärversorgungszentrum der Autoren eine PCI erfolgte.

Ergebnisse

Das durchschnittliche Alter der 213 Patienten betrug 36,8 ± 3,3 Jahre (Spanne: 21–40 Jahre). Im Mittel dauerte die Nachbeobachtungsphase 930 Tage. Die hier untersuchten Patienten waren in der Mehrzahl Männer (88,3 %), und die häufigsten üblichen kardiovaskulären Risikofaktoren waren Rauchen und Fettstoffwechselstörungen. Ein TIMI-Fluss (Thrombolysis-in-myocardial-Infarction-Klassifikation) zu Studienbeginn von 0–1, die geschätzte glomeruläre Filtrationsrate (eGFR) und die Harnsäurewerte stellten sich in der multivariaten Cox-Regressionsanalyse auf lange Sicht als unabhängig mit schweren ungünstigen kardiovaskulären Ereignissen (MACE) korreliert heraus.

Schlussfolgerung

Ein TIMI-Fluss von 0–1, die eGFR bei stationärer Aufnahme und die Harnsäurewerte waren in der vorliegenden Studie mit MACE während der Langzeitnachbeobachtung bei jungen Patienten mit NSTEMI korreliert.

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Funding

This research received no specific grant from any funding agency or from commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Tıbbiye Street No:13, Kadıköy, Istanbul, Turkey

    Yiğit Çanga MD, Ayşe Emre MD, Mehmet Baran Karataş MD, Ali Nazmi Çalık MD, Nizamettin Selçuk Yelgeç MD, Duygu İnan MD, Gizem Yüksel MD & Sait Terzi MD

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  1. Yiğit Çanga MD
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  2. Ayşe Emre MD
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  3. Mehmet Baran Karataş MD
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  4. Ali Nazmi Çalık MD
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  5. Nizamettin Selçuk Yelgeç MD
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  6. Duygu İnan MD
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  7. Gizem Yüksel MD
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  8. Sait Terzi MD
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Correspondence to Yiğit Çanga MD.

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Conflict of interest

Y. Çanga, A. Emre, M.B. Karataş, A.N. Çalık, N.S. Yelgeç, D. İnan, G. Yüksel, and S. Terzi declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Çanga, Y., Emre, A., Karataş, M.B. et al. Prognostic value of serum uric acid levels in patients with non-STEMI undergoing percutaneous coronary intervention. Herz 45, 389–396 (2020). https://doi.org/10.1007/s00059-019-04849-3

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  • DOI: https://doi.org/10.1007/s00059-019-04849-3

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