Uric Acid as a Predictor of All-Cause Mortality in Heart Failure

A Meta-Analysis

Leonardo Tamariz, Arash Harzand, Ana M Palacio, Sameer Verma, John Jones, Joshua Hare

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Serum uric acid (SUA) is a product of xanthine oxidase (XO). Apoptosis and tissue hypoxia lead to increased purine catabolism, which, in turn, increases XO activity and subsequently SUA levels. The purpose of this study was to perform a meta-analysis to evaluate the evidence supporting SUA as a predictor of all-cause mortality in patients with heart failure (HF) and to determine the SUA cut-off for the increase in risk. A search of the MEDLINE database (1966 to March 2009) supplemented by manual searches of bibliographies of key relevant articles was performed. The authors selected all cohort studies in which SUA was measured and mortality was reported in patients with HF. The pooled relative risk (RR) with the corresponding 95% confidence interval (CI) for all-cause mortality using the fixed-effects method was calculated. The effects of SUA on all-cause mortality at different SUA cut-offs using meta-regression was evaluated. The search strategy yielded 358 studies, of which only 6 met our eligibility criteria. The studies, however, comprised 1456 evaluable patients with HF, with a median ejection fraction of 32% (range, 26%-40%). The RR of all-cause mortality was 2.13 (95% CI, 1.78-2.55) for SUA>6.5mg/dL compared with <6.5mg/dL SUA level. There was a linear association (P<.01) between SUA and mortality after 7mg/dL. Uric acid is an important prognostic marker for all-cause mortality in HF. SUA levels >7mg/dL are associated with higher all-cause mortality. Congest Heart Fail. 2011;17:25-30. ©2011 Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)25-30
Number of pages6
JournalCongestive Heart Failure
Volume17
Issue number1
DOIs
StatePublished - Jan 1 2011

Fingerprint

Uric Acid
Meta-Analysis
Heart Failure
Mortality
Serum
Xanthine Oxidase
Confidence Intervals
Conjugated (USP) Estrogens
Bibliography
MEDLINE
Cohort Studies
Databases
Apoptosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency Medicine
  • Emergency

Cite this

Uric Acid as a Predictor of All-Cause Mortality in Heart Failure : A Meta-Analysis. / Tamariz, Leonardo; Harzand, Arash; Palacio, Ana M; Verma, Sameer; Jones, John; Hare, Joshua.

In: Congestive Heart Failure, Vol. 17, No. 1, 01.01.2011, p. 25-30.

Research output: Contribution to journalArticle

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