Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction

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 outcom...

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Main Authors: Prasanta Kumar Bhattacharya, Mayank Agarwal, Debdutta Gautom, Hiranya Saikia
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2016-10-01
Series:National Journal of Laboratory Medicine
Subjects:
Online Access:http://www.njlm.net/articles/PDF/2175/22307_F(GH)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf
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author Prasanta Kumar Bhattacharya
Mayank Agarwal
Debdutta Gautom
Hiranya Saikia
author_facet Prasanta Kumar Bhattacharya
Mayank Agarwal
Debdutta Gautom
Hiranya Saikia
author_sort Prasanta Kumar Bhattacharya
collection DOAJ
description 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.
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spelling doaj.art-8d7786c3ebc54973b28ff7b1fc0658b12022-12-21T23:46:20ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822016-10-0154IO18IO2210.7860/NJLM/2016/22307:2175Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial InfarctionPrasanta Kumar Bhattacharya0Mayank Agarwal1Debdutta Gautom2Hiranya Saikia3Professor & Head, Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India.Post Graduate Student, Department of Medicine, Gauhati Medical College, Guwahati, Assam, India.Post Graduate Student, Department of Medicine, Gauhati Medical College, Guwahati, Assam, India.Senior Lecturer, Department of Community Medicine, Assam Medical College, Dibrugarh, Assam, India.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.http://www.njlm.net/articles/PDF/2175/22307_F(GH)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdfacute coronary syndromebiochemical markerin-hospital mortality
spellingShingle Prasanta Kumar Bhattacharya
Mayank Agarwal
Debdutta Gautom
Hiranya Saikia
Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
National Journal of Laboratory Medicine
acute coronary syndrome
biochemical marker
in-hospital mortality
title Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
title_full Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
title_fullStr Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
title_full_unstemmed Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
title_short Role of Serum Uric Acid Level in Predicting Outcome in Acute Myocardial Infarction
title_sort role of serum uric acid level in predicting outcome in acute myocardial infarction
topic acute coronary syndrome
biochemical marker
in-hospital mortality
url http://www.njlm.net/articles/PDF/2175/22307_F(GH)_PF1(VsuGH)_PFA(GH)_PF2(VsuGH).pdf
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