Background: The aim of this study is to investigate the impact of uric acid on clinical outcomes in patients with angiographically proven coronary artery disease.
Method: Six hundred and forty seven consecutive patients with angiographically proven significant coronary artery disease were enrolled in this retrospective study. Patients were assigned to serum uric acid level >or= 6.4 mg/dL and < 6.4 mg/dL groups based on baseline fasting uric acid levels and determined by a receiver operating characteristic curve. The mean follow-up duration was 4.6 +/- 1.1 years after coronary angiography. The primary endpoints were all cause mortality and death from cardiovascular disease.
Results: The five-year survival rates for patients free from all-cause mortality with levels of uric acid >or= 6.4 mg/dL and < 6.4 mg/dL were 82% and 92% respectively (p < 0.0001). Five-year survival rates for patients free from cardiovascular mortality with levels of uric acid uric acid >or= 6.4 mg/dL and < 6.4 mg/dL were 91% and 97% respectively (p = 0.003). Multivariate Cox regression analysis showed that serum uric acid was an independent predictor of all-cause death (p = 0.01) but was not an independent predictor of cardiovascular mortality (p = 0.063) after adjusting for multi-vessel coronary artery disease, chronic renal insufficiency and a left ventricular ejection fraction < 40%.
Conclusions: After multivariate adjustment, the fasting serum uric acid level was an independent predictor of all-cause mortality, but probably not an independent predictor of cardiovascular mortality in patients with angiographically proven coronary artery disease.