Hyperuricemia: risk factor for thromboembolism in hypertrophic cardiomyopathy patients
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Hyperuricemia has been regarded as a risk factor for various cardiovascular diseases. However, few studies have evaluated its influence on thromboembolism in hypertrophic cardiomyopathy (HCM) patients. The purpose of the present study is to investigate the association between hyperuricemia and thromboembolism in a retrospective HCM cohort. A total of 447 adult HCM patients were enrolled in this study from December 2008 to May 2016. Uric acid levels were measured at baseline. Hyperuricemia was defined as blood uric acid level > 360 µmol/L for female patients and > 420 µmol/L for male patients, respectively. The association between hyperuricemia and thromboembolism was analyzed. During the follow-up period of 1786.8 person-years, 31 patients (6.9%) developed thromboembolic events. There was a higher thromboembolism incidence in patients with hyperuricemia than those with normouricemia (8.9% vs. 5.6%; unadjusted HR 2.35, 95% CI 1.16–4.78, P = 0.018). The association slightly increased after adjusting for potential confounders (HR 2.67, 95% CI 1.24–5.76, P = 0.013). Atrial fibrillation (AF) and left ventricular outflow tract obstruction played an interactive role in the relationship between hyperuricemia and thromboembolism with P for interaction of 0.011 and 0.007, respectively. Adjusted HRs of hyperuricemia were 8.99 (95% CI 2.23–36.29, P = 0.002) for thromboembolism in HCM patients with AF and 6.89 (95% CI 2.23–21.24, P = 0.001) in non-obstructive HCM patients. The association lost statistical significance among patients without AF and obstructive ones. Hyperuricemia significantly predicts future thromboembolism in HCM patients, especially in HCM patients with AF and non-obstructive HCM patients. Future studies are warranted for further evaluation.
KeywordsHyperuricemia Hypertrophic cardiomyopathy Thromboembolism Atrial fibrillation
This study was supported by the National Natural Science Foundation of China (Grant Number: 81600299).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Due to the retrospective nature of the study, informed consent was waived.
- 4.Choi YJ, Choi EK, Do HK et al (2018) Temporal trends of the prevalence and incidence of atrial fibrillation and stroke among Asian patients with hypertrophic cardiomyopathy: a nationwide population-based study. Int J Cardiol 273:130–135. https://doi.org/10.1016/j.ijcard.2018.08.038 CrossRefPubMedGoogle Scholar
- 6.Bos MJ, Koudstaal PJ, Hofman A et al (2006) Uric acid is a risk factor for myocardial infarction and stroke: the Rotterdam Study. Stroke 37:1503–1507. https://doi.org/10.1161/01.STR.0000221716.55088.d4 CrossRefPubMedGoogle Scholar
- 7.Hozawa A, Folsom AR, Ibrahim H et al (2006) Serum uric acid and risk of ischemic stroke: the ARIC Study. Atherosclerosis 187:401–407. https://doi.org/10.1016/j.atherosclerosis.2005.09.020 CrossRefPubMedGoogle Scholar
- 8.Holme I, Aastveit AH, Hammar N et al (2009) Uric acid and risk of myocardial infarction, stroke and congestive heart failure in 417 734 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med 266:558–570. https://doi.org/10.1111/j.1365-2796.2009.02133.x CrossRefPubMedGoogle Scholar
- 10.Zamorano JL, Anastasakis A, Borger MA et al (2014) 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2779. https://doi.org/10.1093/eurheartj/ehu284 CrossRefGoogle Scholar
- 13.Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. Eur Heart J Cardiovasc Imaging 16:233–271. https://doi.org/10.1093/ehjci/jev014 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Ozylmaz S, Satlmolu MH, Gül M et al (2018) Evaluation of the association between serum uric acid level and the predicted risk score of sudden cardiac death in five years in patients with hypertrophic cardiomyopathy. Turk Kardiyol Dern Ars 46:111–120. https://doi.org/10.5543/tkda.2017.60094 CrossRefGoogle Scholar