Higher Serum Uric Acid on Admission Is Associated with Higher Short-term Mortality and Poorer Long-term Survival After Myocardial Infarction: Retrospective Prognostic Study

Aim To assess serum uric acid (SUA) levels determined on admission as a potential predictor of short-term mortality and long-term survival in acute myocardial infarction (AMI) patients, Method Data for this retrospective prognostic study were drawn from the patient database of the Varazdin County General Hospital in Varazdin, Croatia. We included consecutive patients with verified AMI admitted within 48 hours since the symptom onset during the period between 1 January 1996 and 31 December 2001. Long-term survival/mortality data were collected through direct contacts with patients and search of the community death registries. Relative risks (RR) and hazard ratios (HR) by 10 mu mol/L increase in SUA were determined using modified Poisson regression with robust error variance and proportional hazard regression, respectively. Results A total of 621 patients (age 27-90 years, 64.7% men, 77.5% AMI with ST elevation, SUA 63-993 mu mol/L) were included. Higher SUA on admission was independently associated with higher in-hospital mortality (RR, 1.016; 95% confidence interval [Cl], 1.001-1.031, P=0.043) and higher thirty-day mortality (RR, 1.016; 95% Cl, 1.003-1.029, P=0.018). Considered covariates were demographics, pre-index event cardiovascular morbidity and treatment, on-admission serum creatinine, total cholesterol and triglycerides, AMI characteristics, and peak creatine phosphokinase. Higher SUA on admission was also independently associated with poorer long-term survival (ie, higher all-cause mortality) (HR, 1.105; 95% Cl, 1.020-1.195, P=0.010). Considered covariates were demographics, laboratory variables on admission, AMI characteristics, peak creatine phosphokinase, acute complications, and treatment at discharge. Conclusion Higher serum uric acid determined on admission is associated with higher in-hospital mortality and thirty-day mortality and poorer long-term survival after AMI.