Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome
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The role of serum uric acid in coronary artery disease has been extensively investigated. It was suggested that serum uric acid level (SUA) is an independent predictor of endothelial dysfunction and related to coronary artery lesions. However, the relationship between SUA and severity of coronary atherosclerosis evaluated via endothelial dysfunction using peripheral arterial tone (PAT) and the reactive hyperhemia index (RHI) has not been investigated during a first episode of acute coronary syndrome (ACS). The aim of our study was to address this point. We prospectively enrolled 80 patients with a first episode of ACS in a single-center observational study. All patients underwent coronary angiography, evaluation of endothelial function via the RHI, and SUA measurement. The severity of the coronary artery lesion was assessed angiographically, and patients were classified in three groups based on the extent of disease and Gensini and SYNTAX scores. Endothelial function was considered abnormal if RHI < 1.67. We identified a linear correlation between SUA and RHI (R2 = 0.66 P < 0.001). In multivariable analyses, SUA remained associated with RHI, even after adjustment for traditional cardiovascular risk factors and renal function. SUA was associated with severity of coronary artery disease. SUA is associated with severity of coronary atherosclerosis in patients with asymptomatic hyperuricemia. This inexpensive, readily measured biological parameter may be useful to monitor ACS patients.
KeywordsCoronary artery disease First episode of acute coronary syndrome Serum uric acid Endothelial dysfunction
Sophie Rushton-Smith, PhD (MedLink Healthcare Communications Ltd.), provided editorial assistance on the final version and was compensated by the authors.
Compliance with ethical standards
Conflicts of interest
Mélanie Gaubert declares that she has no conflict of interest.
Marion Marlinge declares that she has no conflict of interest.
Marine Alessandrini declares that she has no conflict of interest.
Marc Laine declares that he has no conflict of interest.
Laurent Bonello declares that he has no conflict of interest.
Julien Fromonot declares that he has no conflict of interest.
Jennifer Cautela declares that she has no conflict of interest.
Franck Thuny declares that he has no conflict of interest.
Jeremie Barraud declares that he has no conflict of interest.
Giovanna Mottola declares that he has no conflict of interest.
Pascal Rossi declares that he has no conflict of interest.
Emmanuel Fenouillet declares that he has no conflict of interest.
Jean Ruf declares that he has no conflict of interest.
Régis Guieu declares that he has no conflict of interest.
The study was approved by the hospital’s institutional review board and was conducted in accordance with the Declaration of Helsinki. All patients gave written informed consent.
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