Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
Journal Title: National Journal of Laboratory Medicine - Year 2016, Vol 5, Issue 4
Abstract
Introduction: Acute myocardial infarction (AMI) is one of the leading causes of mortality and morbidity. Various prognostic markers have been used in AMI some of which are expensive and/or not easily available. Aim: To determine the role of serum uric acid levels in predicting short-term outcome in AMI. Materials and Methods: A hospital-based prospective, analytical observational study, in 102 consecutive AMI patients (WHO criteria), ≥ 18 years of age, admitted to the Departments of Medicine and Cardiology. Patients with recurrent myocardial infarction (MI), with additional confounding factors likely to alter serum uric acid levels were excluded. Serum uric acid was measured by using VITROS Uric acid slide method. Statistical Analysis: Unpaired ‘t’ test was used to study association of serum uric acid levels with individual parameters. Unadjusted multivariate logistic regression analysis was used for comparison of variables against in-hospital mortality. A ‘p-value’ <0.05 was considered statistically significant Results: There was a male preponderance (Male:Female = 1.83:1.0) with a mean age of 58.09±13.40 years. Chest pain (73.53%) was the commonest symptom. Anterior-wall was the commonest site (66.67%) and ST-segment elevation MI (STEMI) was the commonest type (55.9%) of MI. One-third (33.3%) of patients had dyslipidemia and over half (57.84%) were hypertensive. Over one-fourth (27.45%) had elevated serum uric acid (>7.0 mg/dl); mean serum uric acid levels were maximum in patients ≥80 years (7.38mg/dl). Mean serum uric acid level was higher in NSTEMI compared to STEMI (5.78mg/ dl vs. 5.59mg/dl; p=0.60). Mean serum uric acid was higher in higher Killip classes (6.58 and 7.38 mg/dl in classes III, IV respectively) compared to lower classes (3.80 & 4.58mg/dl in classes I, II respectively). Higher serum uric acid levels were associated with longer hospital stay (6 days for serum uric acid <4 mg/dl vs 9 days for serum uric acid >7 mg/dl). Overall in-hospital mortality was 9.8%; of which the highest number (70%) had serum uric acid level >7mg/dl (p=0.03). Conclusion: In AMI, patients with a higher Killip class, signifying severe disease, were found to have a higher serum uric acid level. Further, patients with higher serum uric acid had longer hospital stay and significantly higher in-hospital mortality. Serum uric acid may be used as a cheap and effective prognostic indicator in AMI.
Authors and Affiliations
Dr. Prasanta Kumar Bhattacharya, Dr. Mayank Agarwal, Dr. Debdutta Gautom, Dr. Hiranya Saikia
Keywords
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