Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan
BackgroundThe causal relationship between hyperuricemia and cardiovascular diseases is still unknown. We hypothesized that hyperuricemic patients after percutaneous coronary intervention (PCI) had a higher risk of major adverse cardiovascular events (MACE).MethodsThis was a large-scale multicenter c...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1062894/full |
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| author | Naoyuki Akashi Masanari Kuwabara Tetsuya Matoba Takahide Kohro Yusuke Oba Tomoyuki Kabutoya Yasushi Imai Kazuomi Kario Arihiro Kiyosue Yoshiko Mizuno Kotaro Nochioka Masaharu Nakayama Takamasa Iwai Yoko Nakao Yoshitaka Iwanaga Yoshihiro Miyamoto Masanobu Ishii Taishi Nakamura Kenichi Tsujita Hisahiko Sato Hideo Fujita Ryozo Nagai |
| author_facet | Naoyuki Akashi Masanari Kuwabara Tetsuya Matoba Takahide Kohro Yusuke Oba Tomoyuki Kabutoya Yasushi Imai Kazuomi Kario Arihiro Kiyosue Yoshiko Mizuno Kotaro Nochioka Masaharu Nakayama Takamasa Iwai Yoko Nakao Yoshitaka Iwanaga Yoshihiro Miyamoto Masanobu Ishii Taishi Nakamura Kenichi Tsujita Hisahiko Sato Hideo Fujita Ryozo Nagai |
| author_sort | Naoyuki Akashi |
| collection | DOAJ |
| description | BackgroundThe causal relationship between hyperuricemia and cardiovascular diseases is still unknown. We hypothesized that hyperuricemic patients after percutaneous coronary intervention (PCI) had a higher risk of major adverse cardiovascular events (MACE).MethodsThis was a large-scale multicenter cohort study. We enrolled patients with chronic coronary syndrome (CCS) after PCI between April 2013 and March 2019 using the database from the Clinical Deep Data Accumulation System (CLIDAS), and compared the incidence of MACE, defined as a composite of cardiovascular death, myocardial infarction, and hospitalization for heart failure, between hyperuricemia and non-hyperuricemia groups.ResultsIn total, 9,936 patients underwent PCI during the study period. Of these, 5,138 patients with CCS after PCI were divided into two group (1,724 and 3,414 in the hyperuricemia and non-hyperuricemia groups, respectively). The hyperuricemia group had a higher prevalence of hypertension, atrial fibrillation, history of previous hospitalization for heart failure, and baseline creatinine, and a lower prevalence of diabetes than the non-hyperuricemia group, but the proportion of men and age were similar between the two groups. The incidence of MACE in the hyperuricemia group was significantly higher than that in the non-hyperuricemia group (13.1 vs. 6.4%, log-rank P < 0.001). Multivariable Cox regression analyses revealed that hyperuricemia was significantly associated with increased MACE [hazard ratio (HR), 1.52; 95% confidential interval (CI), 1.23–1.86] after multiple adjustments for age, sex, body mass index, estimated glomerular filtration rate, left main disease or three-vessel disease, hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction, and history of hospitalization for heart failure. Moreover, hyperuricemia was independently associated with increased hospitalization for heart failure (HR, 2.19; 95% CI, 1.69–2.83), but not cardiovascular death or myocardial infarction after multiple adjustments. Sensitive analyses by sex and diuretic use, B-type natriuretic peptide level, and left ventricular ejection fraction showed similar results.ConclusionCLIDAS revealed that hyperuricemia was associated with increased MACE in patients with CCS after PCI. Further clinical trials are needed whether treating hyperuricemia could reduce cardiovascular events or not. |
| first_indexed | 2024-04-10T23:49:00Z |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-4802f52aad0545d28405e16498c9d04b2023-01-10T21:05:22ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-01-01910.3389/fcvm.2022.10628941062894Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from JapanNaoyuki Akashi0Masanari Kuwabara1Tetsuya Matoba2Takahide Kohro3Yusuke Oba4Tomoyuki Kabutoya5Yasushi Imai6Kazuomi Kario7Arihiro Kiyosue8Yoshiko Mizuno9Kotaro Nochioka10Masaharu Nakayama11Takamasa Iwai12Yoko Nakao13Yoshitaka Iwanaga14Yoshihiro Miyamoto15Masanobu Ishii16Taishi Nakamura17Kenichi Tsujita18Hisahiko Sato19Hideo Fujita20Ryozo Nagai21Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, JapanDepartment of Cardiology, Toranomon Hospital, Tokyo, JapanDepartment of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, JapanDepartment of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, JapanDivision of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University, Tochigi, JapanDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, JapanDepartment of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, JapanDepartment of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, JapanDepartment of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, JapanDepartment of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan0Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan1Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan1Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan1Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Japan2Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan2Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan2Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan3Precision Inc., Tokyo, JapanDivision of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan4Jichi Medical University, Tochigi, JapanBackgroundThe causal relationship between hyperuricemia and cardiovascular diseases is still unknown. We hypothesized that hyperuricemic patients after percutaneous coronary intervention (PCI) had a higher risk of major adverse cardiovascular events (MACE).MethodsThis was a large-scale multicenter cohort study. We enrolled patients with chronic coronary syndrome (CCS) after PCI between April 2013 and March 2019 using the database from the Clinical Deep Data Accumulation System (CLIDAS), and compared the incidence of MACE, defined as a composite of cardiovascular death, myocardial infarction, and hospitalization for heart failure, between hyperuricemia and non-hyperuricemia groups.ResultsIn total, 9,936 patients underwent PCI during the study period. Of these, 5,138 patients with CCS after PCI were divided into two group (1,724 and 3,414 in the hyperuricemia and non-hyperuricemia groups, respectively). The hyperuricemia group had a higher prevalence of hypertension, atrial fibrillation, history of previous hospitalization for heart failure, and baseline creatinine, and a lower prevalence of diabetes than the non-hyperuricemia group, but the proportion of men and age were similar between the two groups. The incidence of MACE in the hyperuricemia group was significantly higher than that in the non-hyperuricemia group (13.1 vs. 6.4%, log-rank P < 0.001). Multivariable Cox regression analyses revealed that hyperuricemia was significantly associated with increased MACE [hazard ratio (HR), 1.52; 95% confidential interval (CI), 1.23–1.86] after multiple adjustments for age, sex, body mass index, estimated glomerular filtration rate, left main disease or three-vessel disease, hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction, and history of hospitalization for heart failure. Moreover, hyperuricemia was independently associated with increased hospitalization for heart failure (HR, 2.19; 95% CI, 1.69–2.83), but not cardiovascular death or myocardial infarction after multiple adjustments. Sensitive analyses by sex and diuretic use, B-type natriuretic peptide level, and left ventricular ejection fraction showed similar results.ConclusionCLIDAS revealed that hyperuricemia was associated with increased MACE in patients with CCS after PCI. Further clinical trials are needed whether treating hyperuricemia could reduce cardiovascular events or not.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1062894/fullhyperuricemiaserum uric acidchronic coronary syndromepercutaneous coronary interventionreal-world database |
| spellingShingle | Naoyuki Akashi Masanari Kuwabara Tetsuya Matoba Takahide Kohro Yusuke Oba Tomoyuki Kabutoya Yasushi Imai Kazuomi Kario Arihiro Kiyosue Yoshiko Mizuno Kotaro Nochioka Masaharu Nakayama Takamasa Iwai Yoko Nakao Yoshitaka Iwanaga Yoshihiro Miyamoto Masanobu Ishii Taishi Nakamura Kenichi Tsujita Hisahiko Sato Hideo Fujita Ryozo Nagai Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan Frontiers in Cardiovascular Medicine hyperuricemia serum uric acid chronic coronary syndrome percutaneous coronary intervention real-world database |
| title | Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan |
| title_full | Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan |
| title_fullStr | Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan |
| title_full_unstemmed | Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan |
| title_short | Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan |
| title_sort | hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention a nationwide cohort study from japan |
| topic | hyperuricemia serum uric acid chronic coronary syndrome percutaneous coronary intervention real-world database |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1062894/full |
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