Serum uric acid, predicts heart failure in a large Italian cohort: search for a cut-off value the URic acid Right for heArt Health study

被引：60

作者：

Muiesan, Maria L. ^{[1
]}

Salvetti, Massimo ^{[1
]}

Virdis, Agostino ^{[2
]}

Masi, Stefano ^{[2
]}

Casiglia, Edoardo ^{[3
,4
]}

Tikhonoff, Valerie ^{[3
,4
]}

Barbagallo, Carlo M. ^{[5
]}

Bombelli, Michele ^{[6
]}

Cicero, Arrigo F. G. ^{[7
]}

Cirillo, Massimo ^{[8
]}

Cirillo, Pietro ^{[9
]}

Desideri, Giovambattista ^{[10
]}

D'Eliak, Lanfranco ^{[11
]}

Ferri, Claudio ^{[10
]}

Galletti, Ferruccio ^{[11
]}

Gesualdo, Loreto ^{[9
]}

Giannattasio, Cristina ^{[12
,13
]}

Iaccarino, Guido ^{[14
]}

Mallamaci, Francesca ^{[15
]}

Maloberti, Alessandro ^{[12
,13
]}

Mazza, Alberto ^{[16
]}

Nazzaro, Pietro ^{[17
]}

Palatini, Paolo ^{[3
,4
]}

Parati, Gianfranco ^{[18
,19
]}

Pontremoli, Roberto ^{[20
,21
]}

Rattazzi, Marcello ^{[3
,4
,22
]}

Rivasi, Giulia ^{[23
,24
]}

Tocci, Giuliano ^{[25
,26
]}

Ungar, Andrea ^{[23
,24
]}

Verdecchia, Paolo ^{[27
]}

Viazzi, Francesca ^{[20
,21
]}

Volpe, Massimo ^{[25
]}

Grassi, Guido ^{[6
]}

Borghi, Claudio ^{[7
]}

机构：

[1] Univ Brescia, Dept Clin & Expt Sci, C-O 2 Med ASST Spedali Civili Brescia, Brescia, Italy

[2] Univ Pisa, Dept Clin & Expt Med, Pisa, Italy

[3] Univ Padua, Dept Med, Padua, Italy

[4] Univ Padua, Dept Med, Studium Patavinum, Padua, Italy

[5] Univ Palermo, Biomed Dept Internal Med & Specialist, Palermo, Italy

[6] Univ Milano Bicocca, Dept Med & Surg, Clin Med, Monza, Italy

[7] Alma Mater Studiorum Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[8] Univ Salerno, Dept Scuola Med Salernitana, Salerno, Italy

[9] Aldo Moro Univ Bari, Dept Emergency & Organ Transplantat Nephrol, Dialysis & Transplantat Unit, Bari, Italy

[10] Univ Aquila, Dept Life Hlth & Environm Sci, Laquila, Italy

[11] Federico II Univ Naples, Dept Clin Med & Surg, Med Sch, Naples, Italy

[12] Osped Niguarda Ca Granda, A De Gasperis Dept, Cardiol 4, Milan, Italy

[13] Milano Bicocca Univ, Hlth Sci Dept, Milan, Italy

[14] Federico II Univ Naples, Dept Adv Biomed Sci, Naples, Italy

[15] CNR IFC, Clin Epidemiol Renal Dis & Hypertens, Reggio Cal Unit, Reggio Di Calabria, Italy

[16] AULSS 5 Polesana, Dept Internal Med, Santa Maria della Misericordia Gen Hosp, Rovigo, Italy

[17] Univ Bari, Dept Med Basic Sci Neurosci & Sense Organs, Med Sch, Bari, Italy

[18] Ist Auxol Italiano, S Luca Hosp, Dept Cardiovasc Neural & Metab Sci, Milan, Italy

[19] Univ Milano Bicocca, Milan, Italy

[20] Univ Genoa, Dept Internal Med, Genoa, Italy

[21] Policlin San Martino, Genoa, Italy

[22] Ca Foncello Univ Hosp, Med Interna 1, Treviso, Italy

[23] Careggi Hosp, Dept Geriatr & Intens Care Med, Florence, Italy

[24] Univ Florence, Florence, Italy

[25] Univ Rome Sapienza, St Andrea Hosp, Fac Med & Psychol, Dept Clin & Mol Med,Hypertens Unit,Div Cardiol, Rome, Italy

[26] IRCCS Neuromed, Pozzilli, Italy

[27] Hosp S Maria della Misericordia, Perugia, Italy

来源：

JOURNAL OF HYPERTENSION | 2021年 / 39卷 / 01期

关键词：

cut-off value; heart failure; mortality; uric acid; LEFT-VENTRICULAR MASS; CARDIOVASCULAR-DISEASE; DIASTOLIC DYSFUNCTION; OXIDATIVE STRESS; XANTHINE-OXIDASE; ORGAN DAMAGE; HYPERURICEMIA; RISK; ASSOCIATION; MORTALITY;

D O I：

10.1097/HJH.0000000000002589

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Objective: To assess the prognostic cut-off values of serum uric acid (SUA) in predicting fatal and morbid heart failure in a large Italian cohort in the frame of the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension. Methods: The URic acid Right for heArt Health (URRAH) study is a nationwide, multicentre, cohort study involving data on individuals aged 18-95 years, recruited on a community basis from all regions of Italy under the patronage of the Italian Society of Hypertension with a mean follow-up period of 128 +/- 65 months. Incident heart failure was defined on the basis of International Classification of Diseases Tenth Revision codes and double-checked with general practitioners and hospital files. Multivariate Cox regression models having fatal and morbid heart failure as dependent variables, adjusted for sex, age, SBP, diabetes, estimated glomerular filtration rate, smoking habit, ethanol intake, BMI, haematocrit, LDL cholesterol, previous diagnosis of heart failure and use of diuretics as possible confounders, were used to search for an association between SUA as a continuous variable and heart failure. By means of receiver operating characteristic curves, two prognostic cut-off values (one for all heart failure and one for fatal heart failure) were identified as able to discriminate between individuals doomed to develop the event. These cut-off values were used as independent predictors to divide individuals according to prognostic cut-off values in a multivariate Cox models, adjusted for confounders. Results: A total of 21 386 individuals were included in the analysis. In Cox analyses, SUA as a continuous variable was a significant predictor of all [hazard ratio 1.29 (1.23-1.359), P < 0.0001] and fatal [hazard ratio 1.268 (1.121-1.35), P < 0.0001] incident heart failure. Cut-off values of SUA able to discriminate all and fatal heart failure status were identified by mean of receiver operating characteristic curves in the whole database: SUA more than 5.34 mg/dl (confidence interval 4.37-5.6, sensitivity 52.32, specificity 63.96, P < 0.0001) was the univariate prognostic cut-off value for all heart failure, whereas SUA more than 4.89 mg/dl (confidence interval 4.78-5.78, sensitivity 68.29, specificity 49.11, P < 0.0001) for fatal heart failure. The cut-off for all heart failure and the cut-off value for fatal heart failure were accepted as independent predictors in the Cox analysis models, the hazard ratios being 1.645 (1.284-2.109, P < 0.0001) for all heart failure and 1.645 (1.284-2.109, P < 0.0001) for fatal heart failure, respectively. Conclusion: The results of the current study confirm that SUA is an independent risk factor for all heart failure and fatal heart failure, after adjusting for potential confounding variables and demonstrate that a prognostic cut-off value can be identified for all heart failure (>5.34 mg/dl) and for fatal heart failure (>4.89 mg/dl).

引用

页码：62 / 69

页数：8

共 58 条

[1]

Amin Ahmad, 2011, Congest Heart Fail, V17, P80, DOI 10.1111/j.1751-7133.2010.00205.x

[2] Uric acid and survival in chronic heart failure - Validation and application in metabolic, functional, and Hemodynamic staging [J].