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Uric acid prognostic impact on acute heart failure
Session:
Painel 2 -Insuficiencia cardiaca 2
Speaker:
Ana Rita Gomes
Congress:
CPC 2020
Topic:
D. Heart Failure
Theme:
11. Acute Heart Failure
Subtheme:
11.2 Acute Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Ana Rita M. Gomes; Carolina Saleiro; Diana Decampos; Ricardo Ambrosio Rodrigues; João Lopes; José Pedro Sousa; Luís Puga; Joana M. Ribeiro; Natália António; Lino Gonçalves
Abstract
<p><strong>Background:</strong> Elevated uric acid (UA) levels have been associated with poorer prognosis in patients with acute heart failure (AHF), being considered a metabolic and inflammatory marker. This study aims to evaluate UA impact on patients with AHF and different left ventricular ejection fractions (LVEF).</p> <p><strong>Methods:</strong> Retrospective analysis of 207 patients with AHF consecutively admitted to a single Cardiology Department. Patients were divided into two groups according to LVEF, one group had preserved LVEF (≥50%) while the other had non-preserved LVEF (<50%). UA levels were measured during hospital stay. Cox regression analysis was performed to determine prognostic value of UA levels in each group. Receiver operating characteristic (ROC) curve analysis was conducted and area under the curve (AUC) was calculated.</p> <p><strong>Results:</strong> Mean age was 69.1±14.3 years old, 81.2% were males and 17.4% had preserved LVEF. UA levels ranged from 135 to 1298 μmol/L (506.4±168.3 μmol/L). In cox regression analysis, higher levels of UA predicted death in non-preserved LVEF patients (HR 1.002; 95% CI 1.000-1.003; P=0.012), but not in the preserved LVEF group (P=0.909). In multivariate analysis (including age, presence of arterial hypertension, diabetes mellitus, chronic kidney disease and maximum furosemide dose during hospital stay), UA proved to be an independent predictor of mortality (HR 1.002, 95% CI 1.000-1.003, P=0.021), as well as age and chronic kidney disease. For non-preserved LVEF patients, the AUC of UA to predict death was 0.81 (P<0.001, sensitivity 69.9% and specificity 83.9%).</p> <p><strong>Conclusions:</strong> Increased UA levels are associated with greater mortality rates in patients with AHF and non-preserved LVEF, regardless of age, chronic kidney disease and intrahospital dose of furosemide. In contrast, in AHF patients with preserved LVEF, UA did not show prognostic value. These results show the importance of further studies on the role of UA and the possible benefit of UA lowering drugs in AHF.</p>
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