A high level of uric acid is associated with long-term adverse cardiovascular outcomes in patients who received fractional flow reserve with coronary intermediate stenosis

Fanqi Li; Qiuzhen Lin; Jiabao Zhou; Jiayi Zhu; Yong Zhou; Keke Wu; Qiuyu Li; Donghui Zhao; Qiming Liu

doi:10.1016/j.numecd.2024.03.004

A high level of uric acid is associated with long-term adverse cardiovascular outcomes in patients who received fractional flow reserve with coronary intermediate stenosis

Nutr Metab Cardiovasc Dis. 2024 Mar 8:S0939-4753(24)00091-7. doi: 10.1016/j.numecd.2024.03.004. Online ahead of print.

Authors

Fanqi Li¹, Qiuzhen Lin¹, Jiabao Zhou¹, Jiayi Zhu¹, Yong Zhou¹, Keke Wu¹, Qiuyu Li², Donghui Zhao³, Qiming Liu⁴

Affiliations

¹ Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China.
² Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Disease, Beijing 100029, China.
³ Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Disease, Beijing 100029, China. Electronic address: zhaodh_bj@sina.com.
⁴ Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha 410000, China. Electronic address: qimingliu@csu.edu.cn.

PMID: 38644080
DOI: 10.1016/j.numecd.2024.03.004

Abstract

Background and aims: The role of fractional flow reserve (FFR) in coronary intermediate lesions is widely recommended by guidelines. The effect of uric acid (UA) on cardiovascular events is also well known. However, the relationship between UA and long-term cardiovascular outcomes in patients who received FFR with intermediate lesions remains unknown.

Methods and results: We retrospectively included 428 patients who underwent both coronary angiography (CAG) and FFR. Participants were stratified into two groups based on the median UA. The primary endpoint was the composite of major adverse cardiovascular and cerebrovascular events (MACCEs), including repeat revascularization, nonfatal stroke, nonfatal myocardial infarction, and all-cause death. A Cox proportional hazards model was utilized to analyze the association between UA and the prevalence of MACCEs. During a median follow-up of 5.8 years, a higher MACCEs rate occurred in the high UA group compared to the low UA group (16.8% vs. 5.1%, p log-rank<0.01). Elevated UA was independently linked to a higher incidence of MACCEs, whether UA was treated as a categorical or continuous variable (hazard ratio [HR] 2.76, 95% confidence interval [CI] 1.27-6.03 or HR 1.01, 95% CI 1.01-1.02). The restricted cubic spline (RCS) analysis illustrated that the HR for MACCEs increased with increasing UA.

Conclusion: The present study demonstrates that UA is associated with MACCEs risk and suggests that UA is a reliable predictor of long-term cardiovascular events in coronary intermediate stenosis patients.

Keywords: Adverse cardiovascular outcomes; Coronary artery disease; Coronary intermediate lesions; Fractional flow reserve; Uric acid.