Background: Serum uric acid may serve as a marker for the activation of oxidative stress and may therefore be a marker for subsequent cardiovascular events. Our goal was to assess the association of serum uric acid levels and the outcomes of patients who have undergone percutaneous coronary intervention (PCI).
Methods: We performed a retrospective cohort study of patients who underwent PCI between 1/1/2000 and 12/31/2007. Data were retrieved from the Cardiac Lab Interventional Clinical Database as well as the medical records. Outcomes of mortality as well as major adverse cardiac events (MACE) that include death, myocardial infarction (MI), and target vessel revascularization were obtained. There were 10,632 unique patients who had a PCI at the Mayo Clinic in Rochester and allowed use of their records for research. During this time, 1,916 had a uric acid measure within 2 years prior to the day of PCI.
Results: Of the 1,916 patients in our cohort, 1,353 had normal uric acid levels and 563 had elevated uric acid. After multivariable analysis, there was a strong trend in association with follow-up mortality in patients with elevated uric acid (HR = 1.25, 95% CI 0.98-1.59, P = 0.07). The association with mortality or MI (HR = 1.15, 95% CI 0.93-1.43, P = 0.20) and the association with MACE (HR = 1.04, CI 0.86- 1.25, P = 0.71) were not significant.
Conclusions: In a large single-center database with complete follow-up, elevated serum uric acid was associated with increased mortality in PCI patients. These data show a trend for uric acid in the pathophysiology of atherosclerotic coronary artery disease and highlight the need for further research.