Prognostic Value of Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction (from the Japanese Nationwide Multicenter Registry)
Elevated serum uric acid (UA) is associated with an increased risk of cardiovascular disease and worse clinical outcome in patients with cardiovascular disease. Nevertheless, the prognostic value of serum UA level in hospitalized heart failure patients with preserved ejection fraction (HFpEF) has no...
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| Veröffentlicht in: | The American journal of cardiology 2020-03, Vol.125 (5), p.772-776 |
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| creator | Kobayashi, Yuta Omote, Kazunori Nagai, Toshiyuki Kamiya, Kiwamu Konishi, Takao Sato, Takuma Kato, Yoshiya Komoriyama, Hirokazu Tsujinaga, Shingo Iwano, Hiroyuki Yamamoto, Kazuhiro Yoshikawa, Tsutomu Saito, Yoshihiko Anzai, Toshihisa |
| description | Elevated serum uric acid (UA) is associated with an increased risk of cardiovascular disease and worse clinical outcome in patients with cardiovascular disease. Nevertheless, the prognostic value of serum UA level in hospitalized heart failure patients with preserved ejection fraction (HFpEF) has not been fully elucidated. The aim of this study was to investigate whether serum UA level on admission could be associated with subsequent mortality in hospitalized patients with HFpEF. We examined 516 consecutive hospitalized HFpEF (left ventricular ejection fraction ≥50%) patients with decompensated heart failure from our HFpEF-specific multicenter registry who had serum UA data on admission. The primary outcome of interest was all-cause death. During a median follow-up period of 749 (interquartile range 540 to 831) days, 90 (17%) patients died. Higher serum UA level was significantly related to increased incidence of all-cause death (p = 0.016). In addition, patients with higher serum UA (≥6.6 mg/dl, median) and plasma B-type natriuretic peptide (≥401.2 pg/ml, median) levels had the highest incidence of all-cause death in the groups (p = 0.002). In multivariable Cox regression analysis, serum UA was an independent determinant of mortality (hazards ratio 1.23, 95% confidence interval 1.10 to 1.39) even after adjustment for prespecified confounders, renal function and the use of diuretics before admission. In conclusions, higher admission serum UA was an independent determinant of mortality in hospitalized HFpEF patients. Our findings indicate the importance of assessing admission serum UA level for further risk stratification in hospitalized patients with HFpEF. |
| doi_str_mv | 10.1016/j.amjcard.2019.12.003 |
| format | Article |
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Nevertheless, the prognostic value of serum UA level in hospitalized heart failure patients with preserved ejection fraction (HFpEF) has not been fully elucidated. The aim of this study was to investigate whether serum UA level on admission could be associated with subsequent mortality in hospitalized patients with HFpEF. We examined 516 consecutive hospitalized HFpEF (left ventricular ejection fraction ≥50%) patients with decompensated heart failure from our HFpEF-specific multicenter registry who had serum UA data on admission. The primary outcome of interest was all-cause death. During a median follow-up period of 749 (interquartile range 540 to 831) days, 90 (17%) patients died. Higher serum UA level was significantly related to increased incidence of all-cause death (p = 0.016). In addition, patients with higher serum UA (≥6.6 mg/dl, median) and plasma B-type natriuretic peptide (≥401.2 pg/ml, median) levels had the highest incidence of all-cause death in the groups (p = 0.002). In multivariable Cox regression analysis, serum UA was an independent determinant of mortality (hazards ratio 1.23, 95% confidence interval 1.10 to 1.39) even after adjustment for prespecified confounders, renal function and the use of diuretics before admission. In conclusions, higher admission serum UA was an independent determinant of mortality in hospitalized HFpEF patients. Our findings indicate the importance of assessing admission serum UA level for further risk stratification in hospitalized patients with HFpEF.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2019.12.003</identifier><identifier>PMID: 31898963</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Brain natriuretic peptide ; Cardiomyocytes ; Cardiovascular disease ; Cardiovascular diseases ; Clinical outcomes ; Confidence intervals ; Congestive heart failure ; Death ; Diuretics ; Ejection fraction ; Health risks ; Heart failure ; Hospitalization ; Hypoxia ; Inflammation ; Kidney diseases ; Kinases ; Metabolism ; Morbidity ; Mortality ; Regression analysis ; Renal function ; Statistical analysis ; Uric acid ; Ventricle</subject><ispartof>The American journal of cardiology, 2020-03, Vol.125 (5), p.772-776</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-53a21433c70defc071ac7e1431ea0e55061d7c08a07fa27157e568bc0a1c12413</citedby><cites>FETCH-LOGICAL-c393t-53a21433c70defc071ac7e1431ea0e55061d7c08a07fa27157e568bc0a1c12413</cites><orcidid>0000-0002-0159-2648 ; 0000-0002-1267-8260 ; 0000-0003-4063-8212</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2353044446?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31898963$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kobayashi, Yuta</creatorcontrib><creatorcontrib>Omote, Kazunori</creatorcontrib><creatorcontrib>Nagai, Toshiyuki</creatorcontrib><creatorcontrib>Kamiya, Kiwamu</creatorcontrib><creatorcontrib>Konishi, Takao</creatorcontrib><creatorcontrib>Sato, Takuma</creatorcontrib><creatorcontrib>Kato, Yoshiya</creatorcontrib><creatorcontrib>Komoriyama, Hirokazu</creatorcontrib><creatorcontrib>Tsujinaga, Shingo</creatorcontrib><creatorcontrib>Iwano, Hiroyuki</creatorcontrib><creatorcontrib>Yamamoto, Kazuhiro</creatorcontrib><creatorcontrib>Yoshikawa, Tsutomu</creatorcontrib><creatorcontrib>Saito, Yoshihiko</creatorcontrib><creatorcontrib>Anzai, Toshihisa</creatorcontrib><title>Prognostic Value of Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction (from the Japanese Nationwide Multicenter Registry)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Elevated serum uric acid (UA) is associated with an increased risk of cardiovascular disease and worse clinical outcome in patients with cardiovascular disease. Nevertheless, the prognostic value of serum UA level in hospitalized heart failure patients with preserved ejection fraction (HFpEF) has not been fully elucidated. The aim of this study was to investigate whether serum UA level on admission could be associated with subsequent mortality in hospitalized patients with HFpEF. We examined 516 consecutive hospitalized HFpEF (left ventricular ejection fraction ≥50%) patients with decompensated heart failure from our HFpEF-specific multicenter registry who had serum UA data on admission. The primary outcome of interest was all-cause death. During a median follow-up period of 749 (interquartile range 540 to 831) days, 90 (17%) patients died. Higher serum UA level was significantly related to increased incidence of all-cause death (p = 0.016). In addition, patients with higher serum UA (≥6.6 mg/dl, median) and plasma B-type natriuretic peptide (≥401.2 pg/ml, median) levels had the highest incidence of all-cause death in the groups (p = 0.002). In multivariable Cox regression analysis, serum UA was an independent determinant of mortality (hazards ratio 1.23, 95% confidence interval 1.10 to 1.39) even after adjustment for prespecified confounders, renal function and the use of diuretics before admission. In conclusions, higher admission serum UA was an independent determinant of mortality in hospitalized HFpEF patients. Our findings indicate the importance of assessing admission serum UA level for further risk stratification in hospitalized patients with HFpEF.</description><subject>Brain natriuretic peptide</subject><subject>Cardiomyocytes</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Clinical outcomes</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Death</subject><subject>Diuretics</subject><subject>Ejection fraction</subject><subject>Health risks</subject><subject>Heart failure</subject><subject>Hospitalization</subject><subject>Hypoxia</subject><subject>Inflammation</subject><subject>Kidney diseases</subject><subject>Kinases</subject><subject>Metabolism</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Regression analysis</subject><subject>Renal function</subject><subject>Statistical analysis</subject><subject>Uric 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Value of Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction (from the Japanese Nationwide Multicenter Registry)</title><author>Kobayashi, Yuta ; Omote, Kazunori ; Nagai, Toshiyuki ; Kamiya, Kiwamu ; Konishi, Takao ; Sato, Takuma ; Kato, Yoshiya ; Komoriyama, Hirokazu ; Tsujinaga, Shingo ; Iwano, Hiroyuki ; Yamamoto, Kazuhiro ; Yoshikawa, Tsutomu ; Saito, Yoshihiko ; Anzai, Toshihisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-53a21433c70defc071ac7e1431ea0e55061d7c08a07fa27157e568bc0a1c12413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Brain natriuretic peptide</topic><topic>Cardiomyocytes</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Clinical outcomes</topic><topic>Confidence intervals</topic><topic>Congestive heart failure</topic><topic>Death</topic><topic>Diuretics</topic><topic>Ejection fraction</topic><topic>Health risks</topic><topic>Heart failure</topic><topic>Hospitalization</topic><topic>Hypoxia</topic><topic>Inflammation</topic><topic>Kidney diseases</topic><topic>Kinases</topic><topic>Metabolism</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Regression analysis</topic><topic>Renal function</topic><topic>Statistical analysis</topic><topic>Uric acid</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kobayashi, Yuta</creatorcontrib><creatorcontrib>Omote, Kazunori</creatorcontrib><creatorcontrib>Nagai, Toshiyuki</creatorcontrib><creatorcontrib>Kamiya, Kiwamu</creatorcontrib><creatorcontrib>Konishi, Takao</creatorcontrib><creatorcontrib>Sato, Takuma</creatorcontrib><creatorcontrib>Kato, Yoshiya</creatorcontrib><creatorcontrib>Komoriyama, Hirokazu</creatorcontrib><creatorcontrib>Tsujinaga, 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Toshihisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction (from the Japanese Nationwide Multicenter Registry)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>125</volume><issue>5</issue><spage>772</spage><epage>776</epage><pages>772-776</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>Elevated serum uric acid (UA) is associated with an increased risk of cardiovascular disease and worse clinical outcome in patients with cardiovascular disease. Nevertheless, the prognostic value of serum UA level in hospitalized heart failure patients with preserved ejection fraction (HFpEF) has not been fully elucidated. The aim of this study was to investigate whether serum UA level on admission could be associated with subsequent mortality in hospitalized patients with HFpEF. We examined 516 consecutive hospitalized HFpEF (left ventricular ejection fraction ≥50%) patients with decompensated heart failure from our HFpEF-specific multicenter registry who had serum UA data on admission. The primary outcome of interest was all-cause death. During a median follow-up period of 749 (interquartile range 540 to 831) days, 90 (17%) patients died. Higher serum UA level was significantly related to increased incidence of all-cause death (p = 0.016). In addition, patients with higher serum UA (≥6.6 mg/dl, median) and plasma B-type natriuretic peptide (≥401.2 pg/ml, median) levels had the highest incidence of all-cause death in the groups (p = 0.002). In multivariable Cox regression analysis, serum UA was an independent determinant of mortality (hazards ratio 1.23, 95% confidence interval 1.10 to 1.39) even after adjustment for prespecified confounders, renal function and the use of diuretics before admission. In conclusions, higher admission serum UA was an independent determinant of mortality in hospitalized HFpEF patients. Our findings indicate the importance of assessing admission serum UA level for further risk stratification in hospitalized patients with HFpEF.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31898963</pmid><doi>10.1016/j.amjcard.2019.12.003</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-0159-2648</orcidid><orcidid>https://orcid.org/0000-0002-1267-8260</orcidid><orcidid>https://orcid.org/0000-0003-4063-8212</orcidid></addata></record> |
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| subjects | Brain natriuretic peptide Cardiomyocytes Cardiovascular disease Cardiovascular diseases Clinical outcomes Confidence intervals Congestive heart failure Death Diuretics Ejection fraction Health risks Heart failure Hospitalization Hypoxia Inflammation Kidney diseases Kinases Metabolism Morbidity Mortality Regression analysis Renal function Statistical analysis Uric acid Ventricle |
| title | Prognostic Value of Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction (from the Japanese Nationwide Multicenter Registry) |
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