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Higher serum uric acid is associated with higher risks of thrombosis and death in patients with primary myelofibrosis

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Summary

Background

Serum uric acid (SUA) can promote inflammation and is associated with increased cardiovascular morbidity. Primary (PMF) and secondary myelofibrosis (SMF) are myeloproliferative neoplasms characterized by high cellular turnover and substantial risk of thrombosis and death.

Methods

We have retrospectively investigated SUA in 173 patients with myelofibrosis (125 PMF; 48 SMF) and 30 controls.

Results

The PMF patients had significantly higher SUA in comparison to SMF and controls. In both PMF and SMF higher SUA was significantly associated with arterial hypertension and decreased renal function. Among PMF patients, higher SUA was significantly associated with older age, larger spleen, higher white blood cell counts, higher lactate dehydrogenase, lower immunoglobulin G levels, allopurinol use and non-smoking. Among SMF patients, higher SUA was associated with male sex (P < 0.05 for all analyses).

In PMF higher SUA was univariately associated with inferior survival (> 427 μmol/L hazard ratio (HR) = 2.22; P = 0.006) and shorter time to thrombosis (> 444 μmol/L HR = 5.05; P = 0.006), which could be shown separately for arterial (> 380 μmol/L; HR = 4.9; P = 0.013) and venous thromboses (> 530 μmol/L; HR = 17.9; P < 0.001). In multivariate analyses, SUA remained significantly associated with inferior survival independent of the Dynamic International Prognostic Staging System and with shorter time to thrombosis independent of age in PMF patients; however, the prognostic significance of SUA was diminished after including serum creatinine in the models. SUA was not prognostic in SMF patients.

Conclusion

The PMF patients present with higher SUA levels, which are associated with features of more advanced disease and higher risks of arterial and venous thrombosis and death.

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Author information

Authors and Affiliations

  1. Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia

    Marko Lucijanic MD PhD, Martina Sedinic, Vlatko Pejsa & Rajko Kusec

  2. School of Medicine, University of Zagreb, Ul. Salata 3, 10000, Zagreb, Croatia

    Marko Lucijanic MD PhD, Tajana Stoos-Veic, Vlatko Pejsa & Rajko Kusec

  3. Hematology Department, General Hospital Sibenik, Ul. Stjepana Radića 83, 22000, Sibenik, Croatia

    Ivan Krecak

  4. Department of Hematology, University Hospital of Split, Soltanska ul. 1, 21000, Split, Croatia

    Davor Galusic

  5. Department of Internal Medicine, “Dr. Josip Bencevic” General Hospital, Ul. Andrije Štampara, 35000, Slavonski Brod, Croatia

    Hrvoje Holik

  6. Department of Hematology, Osijek University Hospital, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia

    Vlatka Perisa

  7. Faculty of Medicine, University of Osijek, Ul. Josipa Huttlera 4, 31000, Osijek, Croatia

    Vlatka Perisa

  8. Department of Internal Medicine, General Hospital Zadar, Ul. Boze Pericica 5, 23000, Zadar, Croatia

    Martina Moric Peric & Ivan Zekanovic

  9. Department of Clinical Cytology and Cytometry, University Hospital Dubrava, Av. Gojka Suska 6, 10000, Zagreb, Croatia

    Tajana Stoos-Veic

Authors
  1. Marko Lucijanic MD PhD
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Corresponding author

Correspondence to Marko Lucijanic MD PhD.

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Conflict of interest

M. Lucijanic, I. Krecak, D. Galusic, M. Sedinic, H. Holik, V. Perisa, M. Moric Peric, I. Zekanovic, T. Stoos-Veic, V. Pejsa, and R. Kusec declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review boards. All subjects in whom molecular studies were performed provided written informed consent.

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Lucijanic, M., Krecak, I., Galusic, D. et al. Higher serum uric acid is associated with higher risks of thrombosis and death in patients with primary myelofibrosis. Wien Klin Wochenschr 134, 97–103 (2022). https://doi.org/10.1007/s00508-020-01802-x

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