Correlation between Serum Uric Acid Level and Severity of Coronary Artery Stenosis in Patients with Acute Coronary Syndrome

Diding Heri Prasetyo, Sally Aman Nasution, Idrus Alwi, Murdani Abdullah

Abstract


Acute coronary syndrome (ACS) is a life-threatening disease which remains one of the causes of high morbidity and mortality despite the current advances in treatment. The relationship between the serum uric acid  (SUA) level and ischemic heart disease continues to be controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between the two factors has not yet fully understood. Prior epidemiological evidence of the causal relationship between the too is still argumentative. Various studies have been done using the same methods; yet, the outcomes were different. This study aimeds to conduct a meta-analysis to synthesize the results of recent studies in order to obtain accurate quantitative data. This systematic study followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guideline and studies published in the period of  January 2010 to May 2020 were screened using the Cochrane Library, Ebsco, Medline/PubMed, ProQuest and Science Direct as the sources. Meta-analysis was conducted to synthesize the association between the SUA level and severity of coronary artery stenosis using random effect model to account for possible study heterogeneity. Heterogeneity was assessed using I2 and the meta-analysis was performed using Comprehensive Meta Analysis Version 3 (CMA3) software. Five studies (n = 601 subjects) identified a correlation between serum uric acid level and Gensini score (r = 0.548; p <0.001) in ACS patients. Heterogeneity bias was found in the analysis, whereas publication bias was not found. Thus, the severity of coronary artery stenosis in patients with ACS is positively correlated with serum uric acid level.


Keywords


Acute coronary syndromes, Gensini score, uric acid

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References


Chan MY, Du X, Eccleston D, Ma C, Mohanan PP, Ogita M, et al. Acute coronary syndrome in the Asia-Pacific region. Int J Cardiol. 2016;202:861–97. doi:10.1016/j.ijcard.2015.04.073

Anderson JL, Morrow DA. Acute myocardial infarction. N Engl J Med. 2017;376(21):2053–64.

Kuwabara M. Hyperuricemia, cardiovascular disease, and hypertension. Pulse. 2016;3(3–4):242–52. doi: 10.1159/000443769

Larsen TR, Gerke O, Diederichsen ACP, Lambrechtsen J, Steffensen FH, Sand NP, et al. The association between uric acid levels and different clinical manifestations of coronary artery disease. Coron Artery Dis. 2018;29(3):194–203. doi: 10.1097/MCA.0000000000000593

Ndrepepa G. Uric acid and cardiovascular disease. Clin Chim Acta. 2018;484:150–63.

Qureshi AE, Hameed S, Noeman A. Relationship of serum uric acid level and angiographic severity of coronary artery disease in male patients with acute coronary syndrome. Pakistan J Med Sci. 2013;29(5):1137–42. doi: 10.12669/pjms.295.4029

Lan M, Liu B, He Q. Evaluation of the association between hyperuricemia and coronary artery disease A STROBE-compliant article. Med (United States). 2018; 97(44):e12926.

George J, Kataria SP, Isser HS. The corelation of serum uric acid with risk factors and severity of coronary artery disease (CAD) in acute coronary syndrome. International Journal of Contemporary Medicine Surgery and Radiology. 2019;4(4):D107–12.

Gaubert M, Marlinge M, Alessandrini M, Laine M, Bonello L, Fromonot J, et al. Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome. Purinergic Signal. 2018;14(2):191–9. doi: 10.1007/s11302-018-9604-9

Duran M, Kalay N, Akpek M, Orscelik O, Elcik D, Ocak A, et al. High levels of serum uric acid predict severity of coronary artery disease in patients with acute coronary syndrome.

Angiology. 2012;63(6):448–52. doi: 10.1177/0003319711426868

Pramanik S, Mondal K, Dey AK, Mandal PK, Das SK, Momin TW, et al. A study of angiographic severity in patients with coronary artery disease and hyperuricemia. Asian J Med Sci. 2015;7(2):1–4.

Ma QQ, Yang XJ, Yang NQ, Liu L, Li XD, Zhu K, et al. Study on the levels of uric acid and high-sensitivity C-reactive protein in ACS patients and their relationships with the extent of the coronary artery lesion. Eur Rev Med Pharmacol Sci. 2016;20(20):4294–8.

Fromonot J, Deharo P, Bruzzese L, Cuisset T, Quilici J, Bonatti S, et al. Adenosine plasma level correlates with homocysteine and uric acid concentrations in patients with coronary artery disease. Can J Physiol Pharmacol. 2016;94.(3):272–7. doi: 10.1139/cjpp-2015-0193

Wu MY, Yiang GT, Liao WT, Tsai APY, Cheng YL, Cheng PW, et al. Current Mechanistic Concepts in Ischemia and Reperfusion Injury. Cell Physiol Biochem. 2018;46(4):1650–67. doi: 10.1159/000489241

Rabadi MM, Kuo MC, Ghaly T, Rabadi SM, Weber M, Goligorsky MS, et al. Interaction between uric acid and HMGB1 translocation and release from endothelial cells. Am J Physiol Renal Physiol. 2012;302(6):F730–41. doi: 10.1152/ajprenal.00520.2011

Zhen H, Gui F. The role of hyperuricemia on vascular endothelium dysfunction. Biomed Rep. 2017;7(4):325–30. doi: 10.3892/br.2017.966.




DOI: https://doi.org/10.15395/mkb.v53n1.2221

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