Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow

王, 苏; WANG, QIAN; Sun, Tao; Krittanawong, Chayakrit; El-Am, Edward; yonghong, niu; Zhang, Hongju; Li, Xiao Dong; Ma, Ning

doi:10.5543/tkda.2022.32035

Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow

niu yonghong, (Tsinghua University, Department of Cardiology, First Affiliated Hospital, Beijing, China)

Hongju ZHANG, (Capital Medical University, Department of Echocardiography, Beijing Children’s Hospital, National Center for Children’s Health, Beijing, China)

Xiao Dong Li, (Department of Cardiology, Shougang Changzhi Steel Hospital, Shanxi, China)

Su WANG, (Capital Medical University, Department of Cardiology, Beijing Anzhen Hospital, Beijing, China)

Qian WANG, (Capital Medical University, Department of Cardiology, Beijing Anzhen Hospital, Beijing, China)

Chayakrit KRITTANAWONG, (Baylor College of Medicine, Department of Cardiology, Houston, Texas, United States of America)

Edward EL-AM, (Indiana University School of Medicine, Department of Medicine, Indianapolis, Indiana, United States of America)

Tao SUN, (Capital Medical University, Department of Cardiology, Beijing Anzhen Hospital, Beijing, China)

Ning MA (Capital Medical University, Department of Echocardiography, Beijing Children’s Hospital, National Center for Children’s Health, Beijing, China)

Türk Kardiyoloji Derneği Arşivi

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Yıl: 2023 Cilt: 51 Sayı: 1 Sayfa Aralığı: 3 - 9 Metin Dili: İngilizce DOI: 10.5543/tkda.2022.32035 İndeks Tarihi: 10-05-2023

Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow

Öz:

Objective: The impact of uric acid on worsening of diastolic function and clinical outcomes in patients with coronary slow flow remains unclear. This study aims to investigate possible associations between serum uric acid, worsening of diastolic function, and major adverse cardiovascular events in coronary slow flow patients. Methods: Blood samples were obtained prospectively from 537 patients who had been angiographically diagnosed with coronary slow flow. Of those, 425 patients underwent comprehensive cardiac function assessment both before and after maximal treadmill exertion by stress echocardiography. The association between serum uric acid and major adverse cardiovascular events was examined using Cox proportional hazards regression model. Results: Among the 425 patients (mean age: 58 ± 11 years; 52.2% men), worsening of diastolic function occurred in 176 (41.4%) after exercise stress. Patients with worsening of diastolic function had elevated levels of serum uric acid compared to those without (5.7 [4.1, 6.7] vs 4.3 [3.6, 5.3] mg/dL, respectively; P < .001). Higher serum uric acid levels were also significantly associated with neutrophil counts and high-sensitive C-reactive protein in patients with worsening of diastolic function but not in those without. Multivariate regression analysis found serum uric acid to be an independent predictor of worsening of diastolic function (odds ratio = 1.87 [1.17-3.82], P = .023). Moreover, serum uric acid remained associated with major adverse cardiovascular events even after adjusting for echocardiographic and clinical variables (hazard ratio = 1.56 [1.03-2.89], P = .016). Conclusion: Serum uric acid is associated with worsening of diastolic function and may be mediated by inflammation. These findings indicate that uric acid is a risk factor for major adverse cardiovascular events in patients with coronary slow flow.

Anahtar Kelime:

Ürik Asitin Koroner Yavaş Akımlı Hastalarda Diyastolik Fonksiyonunun Kötüleşmesi ve Advers Sonuçlarla İlişkisi

Öz:

Amaç: Koroner yavaş akımlı hastalarda ürik asidin diyastolik fonksiyonun kötüleşmesi ve klinik sonuçlar üzerindeki etkisi belirsizliğini korumaktadır. Bu çalışma, koroner yavaş akım hastalarında serum ürik asit, diyastolik fonksiyonun kötüleşmesi ve majör advers kardiyovasküler olaylar arasındaki olası ilişkileri araştırmayı amaçlamaktadır. Yöntemler: Anjiyografik olarak koroner yavaş akım tanısı konulan 537 hastadan prospektif olarak kan örnekleri alındı. Bunlardan 425 hastaya stres ekokardiyografi ile maksimum koşu bandı eforunun hem öncesinde hem de sonrasında kapsamlı kardiyak fonksiyon değerlendirmesi yapıldı. Serum ürik asit ile majör advers kardiyovasküler olaylar arasındaki ilişki, Cox orantılı tehlikeler regresyon modeli kullanılarak incelendi. Bulgular: 425 hastadan (ortalama yaş: 58 ± 11 yıl; %52,2 erkek) 176’sında (%41,4) egzersizstresinden sonra diyastolik fonksiyonda kötüleşme meydana geldi. Diyastolik fonksiyonu kötüleşen hastalarda, diğerlerine kıyasla serum ürik asit seviyeleri yüksekti (sırasıyla 5,7 [4.1, 6.7] ve 4.3 [3.6, 5.3] mg/dL; P < .001). Yüksek serum ürik asit seviyeleri, diyastolik fonksiyonu kötüleşen hastalarda nötrofil sayıları ve yüksek duyarlı C-reaktif protein ile de anlamlı şekilde ilişkiliydi, ancak yüksek olmayanlarda böyle bir ilişki yoktu. Çok değişkenli regresyon analizi, serum ürik asidin diyastolik fonksiyonun kötüleşmesinin bağımsız bir öngörücüsü olduğunu ortaya koydu (odds oranı = 1.87 [1.17-3.82], P = .023). Ayrıca, serum ürik asit, ekokardiyografik ve klinik değişkenler için düzeltme yapıldıktan sonra bile majör advers kardiyovasküler olaylarla ilişkili bulundu (risk oranı = 1.56 [1.03-2.89], P = .016). Sonuç: Serum ürik asit, diyastolik fonksiyonun kötüleşmesi ile ilişkilidir ve inflamasyon aracılık edebilir. Bu bulgular, ürik asidin koroner yavaş akımı olan hastalarda majör advers kardiyovasküler olaylar için bir risk faktörü olduğunu göstermektedir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	yonghong n, Zhang H, Li X, 王苏, WANG Q, Krittanawong C, El-Am E, Sun T, Ma N (2023). Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. , 3 - 9. 10.5543/tkda.2022.32035
Chicago	yonghong niu,Zhang Hongju,Li Xiao Dong,王苏,WANG QIAN,Krittanawong Chayakrit,El-Am Edward,Sun Tao,Ma Ning Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. (2023): 3 - 9. 10.5543/tkda.2022.32035
MLA	yonghong niu,Zhang Hongju,Li Xiao Dong,王苏,WANG QIAN,Krittanawong Chayakrit,El-Am Edward,Sun Tao,Ma Ning Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. , 2023, ss.3 - 9. 10.5543/tkda.2022.32035
AMA	yonghong n,Zhang H,Li X,王苏,WANG Q,Krittanawong C,El-Am E,Sun T,Ma N Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. . 2023; 3 - 9. 10.5543/tkda.2022.32035
Vancouver	yonghong n,Zhang H,Li X,王苏,WANG Q,Krittanawong C,El-Am E,Sun T,Ma N Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. . 2023; 3 - 9. 10.5543/tkda.2022.32035
IEEE	yonghong n,Zhang H,Li X,王苏,WANG Q,Krittanawong C,El-Am E,Sun T,Ma N "Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow." , ss.3 - 9, 2023. 10.5543/tkda.2022.32035
ISNAD	yonghong, niu vd. "Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow". (2023), 3-9. https://doi.org/10.5543/tkda.2022.32035

APA	yonghong n, Zhang H, Li X, 王苏, WANG Q, Krittanawong C, El-Am E, Sun T, Ma N (2023). Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. Türk Kardiyoloji Derneği Arşivi, 51(1), 3 - 9. 10.5543/tkda.2022.32035
Chicago	yonghong niu,Zhang Hongju,Li Xiao Dong,王苏,WANG QIAN,Krittanawong Chayakrit,El-Am Edward,Sun Tao,Ma Ning Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. Türk Kardiyoloji Derneği Arşivi 51, no.1 (2023): 3 - 9. 10.5543/tkda.2022.32035
MLA	yonghong niu,Zhang Hongju,Li Xiao Dong,王苏,WANG QIAN,Krittanawong Chayakrit,El-Am Edward,Sun Tao,Ma Ning Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. Türk Kardiyoloji Derneği Arşivi, vol.51, no.1, 2023, ss.3 - 9. 10.5543/tkda.2022.32035
AMA	yonghong n,Zhang H,Li X,王苏,WANG Q,Krittanawong C,El-Am E,Sun T,Ma N Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. Türk Kardiyoloji Derneği Arşivi. 2023; 51(1): 3 - 9. 10.5543/tkda.2022.32035
Vancouver	yonghong n,Zhang H,Li X,王苏,WANG Q,Krittanawong C,El-Am E,Sun T,Ma N Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow. Türk Kardiyoloji Derneği Arşivi. 2023; 51(1): 3 - 9. 10.5543/tkda.2022.32035
IEEE	yonghong n,Zhang H,Li X,王苏,WANG Q,Krittanawong C,El-Am E,Sun T,Ma N "Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow." Türk Kardiyoloji Derneği Arşivi, 51, ss.3 - 9, 2023. 10.5543/tkda.2022.32035
ISNAD	yonghong, niu vd. "Uric Acid Is Associated with Worsening of Diastolic Function and Adverse Outcomes in Patients with Coronary Slow Flow". Türk Kardiyoloji Derneği Arşivi 51/1 (2023), 3-9. https://doi.org/10.5543/tkda.2022.32035