engleski

On-admission serum uric acid predicts outcomes after acute myocardial infarction: Systematic review and metaanalysis of prognostic studies

Aim was tTo evaluate the prognostic value of serum uric acid (SUA) in acute myocardial infarction (AMI) patients. Method was a ystematic review and random-effects metaanalysis of prognostic studies assessing AMI outcomes (death, major adverse cardiac events, MACE) in relation to on-admission SUA. Nine studies (7655 patients) were identified, 6 in the ST-segment elevation AMI patients treated with invasive revascularization and three in mixed AMI type cohorts with variable reperfusion strategies. "High" SUA (vs "low, " different cut-offs) was univariately associated with higher short-term mortality (8 studies/6805 patients ; odds ratio [OR], 3.24 ; 95% confidence interval [CI], 2.47-4.27) and incidence of MACE (7/6467 ; OR, 2.46 ; 95% CI, 1.84-3.27, moderate heterogeneity, mild bias), and with higher medium-term mortality (5/5194 ; OR, 2.69 ; 95% CI, 2.00-3.62, moderate heterogeneity, mild bias) and MACE (4/4299 ; OR, 1.93 ; 95% CI, 1.36-2.74, high heterogeneity, mild bias). It was independently associated with a higher short-term (4/3625 ; OR, 2.26, 95% CI, 1.85-2.77) and medium/longterm (3/2683 ; hazard ratio [HR], 1.30 ; 95% CI 1.01-1.68, moderate heterogeneity, mild bias) occurrence of poor outcomes (death/MACE). As a continuous variable (by 50 μmol/L), higher SUA was also independently associated with poorer medium/long-term outcomes (4/3533 ; HR, 1.19 ; 95% CI, 1.03-1.37, high heterogeneity, mild bias). All individual study effects (unadjusted or adjusted) were in the same direction, but differed in size. Heterogeneity was mainly due to the included AMI type and/or definition of MACE. All bias-corrected pooled effects remained significant. Based on the available data, high(er) on-admission SUA independently predicts worse short-term and medium/long-term outcomes after AMI. However, the number of data are modest and additional prospective studies are warranted

acute heart infarction; article; death; heart disease; hospital admission; human; meta analysis; mortality; non ST segment elevation myocardial infarction; outcome assessment; predictive value; prognosis; revascularization; ST segment elevation myocardial infarction; systematic review; uric acid blood level

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