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Serum uric acid levels prognostic value in chronic heart failure patients with reduced ejection fraction
Session:
Posters (Sessão 5 - Écran 4) - Insuficiência Cardíaca 5 - Marcadores Serológicos
Speaker:
Pedro Rocha Carvalho
Congress:
CPC 2022
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.5 Chronic Heart Failure – Prevention
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Pedro Rocha Carvalho; Jose Monteiro; Catarina Carvalho; Marta Bernardo; Ana Baptista; Rita Godinho; Miguel Moz; Paulo Fontes; Ilidio Moreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:black">Introduction:</span></span></span></span></strong><span style="font-size:12.0pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:black"> The relationship between serum uric acid (UA) and cardiovascular disease has been a matter of debate over the last years. Increased l</span></span></span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">evels of UA may be either a marker of poor prognosis, which could be used in conjunction with other risk factors, or an active player in the pathogenesis of heart failure (HF) and thereby representing a novel and attractive therapeutic target. <br /> <br /> <strong><span style="background-color:white">Purpose:</span></strong><span style="background-color:white"> To study the prognostic impact of high levels of UA in patients with HF with reduced ejection fraction (HFrEF). </span><br /> <br /> <strong><span style="background-color:white">Methods:</span></strong><span style="background-color:white"> Retrospective study of consecutive patients admitted to a single heart failure outpatient clinic from February/2018 to December/2020, with an initial left ventricular ejection fraction (LVEF) <50%. The primary outcome was cardiovascular mortality.</span><br /> <br /> <strong><span style="background-color:white">Results:</span></strong><span style="background-color:white"> A total of 267 patients were selected, with a mean age of 71,1±11,1 years old, 69,0% were males and 40,0% had ischemic cardiomyopathy. In the initial evaluation, 31,5% had UA levels ≥7 mg/dl. These patients were mostly man (83,7% vs 62,6%, p<0,001) and had higher diuretic doses (30,2% vs 20,2%, p=0,071), but had less arterial systemic hypertension (61,4% vs 72,8%, p=0,041). Both groups had similar age (70,9±11,8 vs 71,4±10,6 years, p=0,727) and LVEF (30,1±10,1% vs 31,2±7,7%, p=0,323). Incidence of diabetes <em>mellitus</em> (35,1% vs 34,1%, p=0,868), active or previous smoking history (11,7% vs 7,0%, p=0,456 and 24,7% vs 24,9%, p=0,456, respectively), functional NYHA class ≥ 2 (93,8% vs 94,1%, p=0,207), chronic kidney disease (15,4% vs 11,0%, p=0,327) and allopurinol prescription (21,2% vs 14,0%, p=0,151) were also comparable between both groups.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:black">During a median follow-up of 17 months (IQR 14–31), 17 patients (6,4%) experienced the primary outcome. After adjusting for sex, arterial hypertension and diuretic doses, UA levels ≥7mg/dl on the first evaluation were an independent predictor of cardiovascular death in HFrEF (HR 2,73, 95% CI: 1,01-7,42).</span></span></span></span></span></span></p> <p style="text-align:justify"><br /> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black"><strong><span style="background-color:white">Conclusion:</span></strong><span style="background-color:white"> In our heart failure outpatient clinic, patients with HFrEF with UA levels ≥7mg/dl on the first evaluation had a higher risk of cardiovascular death. Larger randomized controlled trials are needed to predict the real significance and the eventual benefit of a new treatment approach for this patients. </span></span></span></span></span></span></p>
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