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.
- 2.Kanbay M, Segal M, Afsar B, Kang D-H, Rodriguez-Iturbe B, Johnson RJ (2013) The role of uric acid in the pathogenesis of human cardiovascular disease. Heart Br Card Soc 99:759–766Google Scholar
- 9.Sianos G, Morel M-A, Kappetein AP, Morice M-C, Colombo A, Dawkins K, van den Brand M, Van Dyck N, Russell ME, Mohr FW, Serruys PW (2005) The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention J Eur Collab Work Group Interv Cardiol Eur Soc Cardiol 1:219–227Google Scholar
- 14.Canepa M, Viazzi F, Strait JB, Ameri P, Pontremoli R, Brunelli C, Studenski S, Ferrucci L, Lakatta EG, AlGhatrif M (2017) Longitudinal association between serum uric acid and arterial stiffness: results from the Baltimore longitudinal study of aging. Hypertension 69:228–235CrossRefPubMedGoogle Scholar
- 15.Doehner W, Schoene N, Rauchhaus M, Leyva-Leon F, Pavitt DV, Reaveley DA, Schuler G, Coats AJS, Anker SD, Hambrecht R (2002) Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure: results from 2 placebo-controlled studies. Circulation 105:2619–2624CrossRefPubMedGoogle Scholar
- 26.Gariboldi V, Vairo D, Guieu R, Marlingue M, Ravis E, Lagier D, Mari A, Thery E, Collart F, Gaudry M, Bonello L, Paganelli F, Condo J, Kipson N, Fenouillet E, Ruf J, Mottola G (2017) Expressions of adenosine A(2A) receptors in coronary arteries and peripheral blood mononuclear cells are correlated in coronary artery disease patients. Int J Cardiol 230:427–431CrossRefPubMedGoogle Scholar
- 27.Nihei S, Tasaki H, Yamashita K, Ozumi K, Morishita T, Tsutsui M, Okazaki M, Nakashima Y, Adachi T (2004) Hyperhomocysteinemia is associated with human coronary atherosclerosis through the reduction of the ratio of endothelium-bound to basal extracellular superoxide dismutase. Circ J 68:822–828CrossRefPubMedGoogle Scholar
- 28.Guieu R, Kipson N, Ruf J, Fournier N, Laine M, Foucher MC, Fromonot J, Mottola G, Bruzzese L, Boussuges A, Fenouillet E, Bonello L, Paganelli F (2015) Low basal expression of A2A adenosine receptors and increase in adenosine plasmaconcentration are associated with positive exercise stress testing. Int J Cardiol 180:15–17CrossRefPubMedGoogle Scholar
- 29.Ruf J, Paganelli F, Bonello L, Kipson N, Mottola G, Fromonot J, Condo J, Boussuges A, Bruzzese L, Kerbaul F, Jammes Y, Gariboldi V, Franceschi F, Fenouillet E, Guieu R (2016) Spare adenosine a(2a) receptors are associated with positive exercise stress test in coronary artery disease. Mol Med 22:530–536CrossRefPubMedCentralGoogle Scholar
- 36.Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA (2010) Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthritis Care Res 62:170–180Google Scholar