P68 The Hidden Predictor of Cardiovascular Outcome

Background Hyperuricemia is common in patients with hypertension, diabetes and obesity. Whether it is an independent cardiovascular risk factor (CVRF) or not remains controversial. Purpose To determine the prognostic value of uricemia in the setting of acute coronary syndrome (ACS). Methods Retrospective single-center study comprising 1187 patients consecutively admitted into a cardiac intensive care unit for ACS, in whom uricemia was measured during hospitalization. Follow-up targeted all-cause mortality (FUM), reinfarction, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and acute heart failure (AHF). Statistical analysis was performed using SPSS, version 25. Results: Mean age was 68.0 ± 13.3y and 30.4% were female. Prevalence of CVRF was as follows: hypertension, 76.9%; diabetes, 33.4%; dyslipidemia, 65.6%; smoking, 35.5%; chronic kidney disease (CKD), 20.5%. Uricemia was 377 ± 119.2 μmol/l, whereas body mass index (BMI) was 27.8 ± 4.4 kg/ m 2 . In-hospital mortality (IHM) was 6%, while median follow-up time was 6y, encompassing the following event rates: FUM, 36.9%; reinfarction, 19.4%; PCI, 21.1%; CABG, 2.3%; AHF, 16.6%. Uricemia was higher in males (p = 0.001) and in patients with hypertension (p < 0.001), diabetes mellitus (p = 0.009) and CKD (p < 0.001) and lower in patients with dyslipidemia (p = 0.031) and smokers (p = 0.03). Age and BMI displayed weak correlation with uricemia. Hyperuricemia had no effect on the burden of reinfaction, PCI and CABG. In a model of logistic regression including the above-mentioned CVRF, hyperuricemia was an independent predictor of IHM (p = 0.009, Hosmer-Lemeshow p = 0.685), FUM (p < 0.001, Hosmer-Leme-show p - 0.056) and AHF (p = 0.001, Hosmer-Lemeshow p = 0.367). Conclusion Hyperuricemia is an independent predictor of mortality and AHF in the setting of ACS.