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Abstract: SA-PO1109

GFR Adjusted Uric Acid Levels Are a Superior Cardiovascular Outcome and Mortality Predictor Than Uric Acid Levels Alone

Session Information

Category: Pathology and Lab Medicine

  • 1502 Pathology and Lab Medicine: Clinical

Authors

  • Koenigshausen, Eva, Medical Faculty Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
  • Rubel, Johanna, Medical Faculty Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
  • März, Winfried, University Hospital, Mannheim, Germany
  • Rump, Lars C., Medical Faculty Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
  • Sellin, Lorenz, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
Background

Hyperuricemia is associated with increased cardiovascular risk and mortality. Chronic renal failure increases uric acid (UA) levels due to decreased filtration. A formula calculating GFR adjusted UA levels (estimated UA, eUA) has been developed by our group. The aim of this study was to evaluate the potential of eUA levels in predicting cardiovascular outcome and mortality in a cardiovascular risk cohort of patients.

Methods

The relation of GFR and UA levels was investigated with the eUA-formula in the LURIC cohort. LURIC was a prospective cohort study to identify genetic and metabolic risk factors in coronary heart disease. Patients were excluded with GFR levels <10ml/min and >100ml/min because of eUA-formula reasons. Subgroup analysis was performed (eUA < UA as risk group and eUA > UA as control group). Mortality, chronic heart failure (CHF) and cardiac events (CE) were documented outcome parameters. Binary univariate and multivariate logistic regression analysis were performed to study prediction of outcome variables by eUA or UA.

Results

3316 patients were included in the LURIC cohort. Due to GFR, 652 patients were excluded. Of 2654 patients (1774 male) at an age of 64.71 ± 9.21 the GFR was 75.78 ± 16.98 ml/min. UA levels were measured with 5.24 ± 1.75 mg/dl. 686 patients (25.8%) died of all-cause mortality during the follow up period of the study. Mean UA levels in the subgroups did not differ. GFR was significantly lower in the risk group vs. the control group. Mortality and CHF NYHA > 1 were significantly higher in the risk group than in the control group (OR 1.35 and 1.65), while no differences were noted for CE. Univariate analysis revealed a significant benefit of using the eUA model compared to the classic UA model in predicting mortality (OR 1.8 vs. 1.23; -2LL 2874.32 vs. 2962.33) and CE (OR 1.54 vs. 1.16; -2LL 3231.37 vs. 3301.27). Multivariate regression analysis showed a significant better prediction of the outcome variables mortality (OR 6.06 vs. 1.25; -2LL 2187.17 vs. 2264.13), CHF (OR 2.96 vs. 1.65; -2LL 3160.43 vs. 3170.40) and CE (OR 2.35 vs. 1.48; -2LL 2445.85 vs. 2474.54) in the adjusted eUA-model compared to the UA-model group.

Conclusion

GFR adjusted uric acid (eUA) levels predict cardiovascular outcome significantly better in a cardiovascular risk cohort than uric acid levels alone.