Association of Uric Acid and C-reactive Protein with the Severity of Coronary Artery Disease Using SYNTAX Score and Clinical SYNTAX Score

Background: The SYNTAX score (SXscore), an anatomical-based scoring tool reflecting the complexity of coronary anatomy, has been associated with the mortality and prognosis of coronary artery disease (CAD). Clinical SYNTAX score (CSS), incorporating clinical factors further augmented the utility of the SXscore to longer-term risk. C-reactive protein (CRP) is related to SXscore. Serum uric acid (UA) is associated with atherosclerosis and CAD. However, serum uric acid combined with CRP may better predict the SXscore and CSS. Methods: A total of 208 patients (mean age 57.82 +/- 9.39 years) with chest pain were included in this study. All selected subjects underwent coronary artery angiography and blood test. The relationship between serum UA, CRP and SXscore, and CSS were analyzed. Results: Age and CRP had a positive correlation with SXs and CSS. DM and fasting glucose correlated with SXscore and CSS respectively. In multivariate regression, serum UA, age, fasting glucose, and body mass index (BMI) were significant discriminant factors of high CSS. The predictive accuracy of CRP for SXscore >0 and high CSS using receiver operator characteristic curves was set at the cut off point of 0.205 mg/dL and 0.145 mg/dL respectively, (sensitivity 70.9% and 98%, specialty 48% and 23.2%). Conclusion: Serum CRP is correlated with SXscore and CSS, serum UA is independently associated with CSS. CRP predicts high CSS at a lower level than it predicts SXscore. Thus, serum CRP combined with serum UA may be useful to predict SXscore and CSS.