Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group

• DOI: 10.1016/j.ejim.2019.11.003
• Publication Date: 2019-11-28T21:15:11Z
• Authors: Massimo Francesco...; Elisabetta Salvioni; Ugo Corrà; Francesco Doni; Alice Bonomi; Rocco La Gioia; Giuseppe Limongelli; Stefania Paolillo; Gianfranco Sinagra; Angela B. Scardovi; Rosa Raimondo; Michele Emdin; Federica Re; Mariantonietta Ci...; Michele Correale; Roberto Badagliacca; Francesco Clemenza; Carlo Lombardi; Piergiuseppe Agos...
• Keywords: Heart Failure; Male; Stroke Volume; Middle Aged; Prognosis; Uric Acid; 3. Good health; heart failure; prognosis; uric acid; Ventricular Dysfunction, Left; 03 medical and health sciences; 0302 clinical medicine; Cardiopulmonary exercise test; Heart failure; Hemoglobin; Kidney function; Uric acid, prognosis; Aged; Humans; Male; Middle Aged; Prognosis; Stroke Volume; Uric Acid; Heart Failure; Ventricular Dysfunction, Left; Humans; Cardiopulmonary exercise test; Heart failure; Hemoglobin; Kidney function; Uric acid, prognosis; cardiopulmonary exercise test; heart failure; hemoglobin; kidney function; uric acid, prognosis; aged; humans; male; middle aged; prognosis; stroke volume; uric acid; heart failure; ventricular dysfunction, left; Aged

Hyperuricemia prognostic impact on clinical outcomes in chronic heart failure (HF) patients has been investigated with inconclusive results.Aim of the study was to evaluate the prognostic impact of serum uric acid (SUA) on long-term clinical outcomes in HF.An analysis of MECKI (Metabolic Exercise Cardiac Kidney Index) database, with median follow-up of 3.4 years.Relation between SUA and all-cause/ cardiovascular (CV) deaths have been analysed in 4,577 patients (3,688 males, age 62.7 ± 12.9 years), with reduced ejection fraction HF (35 ± 11%), peakVO2 1151 ± 440 ml/min; NYHA class I-II (72.6%), III-IV (27.4%). SUA was associated with increased total and CV mortality (HR 1.120 and HR 1.128, respectively p < 0.0001), also after adjustment for peakVO2, VE/VCO2 slope, diuretic use and MECKI score. SUA was significantly associated with CV mortality only in NYHA class I-II (HR 1.17, p < 0.0001) while there was no association in class III-IV (HR 1.03, p = NS). No prognostic added values of SUA with respect to the MECKI score was observed at the ROC analysis.SUA is confirmed to be associated with increased mortality, but in less severe HF only. However SUA did not show additional prognostic power to the MECKI score.