Is serum uric acid level an independent predictor of heart failure among patients with coronary artery disease?

Background: Uric acid (UA) is elevated in patients with the metabolic syndrome, and there is a possible association with coronary events. Its association with future risk of heart failure (HF) is not clear. Our objective was to evaluate the association between levels of UA and risk of HF in patients with stable coronary artery disease (CAD). Hypothesis: Serum UA is associated with HF in CAD patients. Methods: A retrospective cohort analysis among 2939 participants of the bezafibrate infarction prevention study, assessing long-term risk of HF incidence over an 8-year of follow-up in relation to baseline UA. Results: Among patients with high levels of UA, there was a larger proportion of men, systolic hypertension, diabetes mellitus, metabolic syndrome, elevated total cholesterol, chronic renal failure, and previous coronary revascularization procedures. The rate of myocardial infarction during the follow-up was 10.9%, 10.3%, and 11.6% in the 1st, 2nd and 3rd tertiles of UA, respectively (P = 0.68). Age-adjusted hazard ratios for HF were 1.16 (95% confidence interval [CI]: 0.94-1.45) and 1.28 (95% CI: 1.04-1.59) in the 2nd and 3rd tertiles, respectively, as compared to the 1st tertile. After adjusting for multiple confounders and myocardial infarction, the hazard ratio for developing HF was 1.18 (95% CI: 0.95-1.47) and 1.25 (95% CI: 1.00-1.56) in the 2nd and 3rd tertiles of UA levels, respectively. Conclusions: UA levels are associated with future risk of HF in patients with stable CAD, but this association is attenuated after adjusting for traditional CAD risk factors. The authors have no funding, financial relationships, or conflicts of interest to disclose.