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Serum Uric Acid As An Independent Predictor of Cardiovascular Event In Patients With Acute ST Elevation Myocardial Infarction

Surya Dharma, Bambang Budi Siswanto, Sunarya Soerianata, Alexander J Wardeh and Jan Wouter Jukema

Background: There is uncertainty whether uric acid level could be used as a prognostic marker in acute ST elevation myocardial infarction (STEMI) patients. Furthermore, there is a need to find a simple, less expensive but accurate marker that could be use in rural areas where fibrinolytic treatment is the first choice of acute reperfusion therapy. We studied the association of uric acid levels on cardiovascular event in patients with STEMI receiving fibrinolytic treatment.
Methods: Seventy-five patients with acute STEMI, eligible for fibrinolytic therapy, were enrolled in this cohort study. Over a night of fasting period, uric acid level was measured. One month clinical follow up was done. Reinfarction, heart failure, urgent revascularization, recurrent angina and death were defined as end point of the study.
Results: In STEMI patients with lowest uric acid levels (<4.8 mg/dl) compared with highest uric acid levels (>7.3 mg/dl), the cardiovascular event rate increased from 8% to 20%. From multivariate Cox regression analysis showed that elevated levels of uric acid (>7.3 mg/dl) demonstrated an independent, significant positive relation to cardiovascular events [Hazard Ratio 3.10 (95% Confidence Interval 1.16 to 8.29), p <0.024].
Conclusion: Serum uric acid is an independent predictor of cardiovascular event in patients with post fibrinolytic treatment in acute STEMI.