ABSTRACT
Background: Present evidence shows that increased uric acid level is a negative prognostic factor in patients with moderate to severe heart failure. A study has highlighted a correlation between serum uric acid levels and Killip class in patients of acute myocardial infarction (AMI). Aim of this study the relationship between serum uric acid level and Killip classification in patients with AMI.Methods: Sixty patients with AMI were studied prospectively in Department of Medicine/ Department of Cardiology, JA Group of Hospitals between 2016-2018. Patients were grouped based on the Killip class. Age, sex, history of smoking, alcohol consumption, hypertension and diabetes were recorded. Serum uric acid level were measured on Day 1, 3 and 5, which was compared with Killip class.Results: Majority of the patients were males (65%) and had age between (28.3%) 51-60 years. No significant association was obtained between any risk factors of AMI and Killip’s class (p>0.05). Serum uric acid levels were significantly higher in Killip grade III (7.80±3.57) as compared to Killip’s grade II (6.64±2.88) and I (6.30±2.33) (p=0.014). Majority of the patients with Killip’s grades I and II, had uric acid level ≤7.0 mg/dl (n=18 and n=9 respectively) (p=0.040). Serum uric acid was equally distributed among different types of killip’s grades between patients who expired and survived. (p>0.05).Conclusions: Serum uric acid levels has been found to be well correlated with Killip classification in patients with AMI. Combination of Killip class and serum uric acid level after AMI is a good predictor of mortality after AMI.
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Importance: The increasing prevalence of dementia worldwide has reduced the quality of life in geriatric patients, therebyincreasing the burden on the caregivers. As dementia evolves gradually, diagnosis of the disease is often delayed. Thus, theneed for a sensitive biomarker for early diagnosis is instrumental.Objective: The objective of the study was to study the association between serum uric acid levels and dementia in geriatric patients.Design: This is a case–control study comparing the age-matched geriatric patients with and without dementia (cases – 50and controls – 50).Setting and Participants: A total of 100 geriatric patients from Government Villupuram Medical College and Hospital wereincluded in this study for a study period of 4 months. Out of this, 50 were cases (with dementia) and 50 were controls (withoutdementia). Mini-mental state examination test was done to categorize the cases into mild, moderate, and severe subgroups(24–30 out of 30 as normal; 20–23 out of 30 as mild; 10–19 out of 30 as moderate; and score lesser than 10 out of 30 as severe).Serum uric acid levels were measured in the study population and compared between the cases and controls.Results: The correlation of serum uric acid levels with cases and controls revealed 16% of the cases had hypouricemia,whereas none in the control group had hypouricemia. When serum uric acid levels were compared, it was found that 44% ofthe control group had normal serum uric acid levels and 82% of the cases had normal serum uric acid levels. Based on minimental state examination score, 10% of mild group and 21% of moderate group had hypouricemia and 4% of moderate grouphad hyperuricemia while the others had normal serum uric acid levels. All the data were statistically significant with “P” < 0.001.Conclusion: The study identified the prevalence of hypouricemia in the study population. This study can pave the path forfurther multicentric research to delineate the role of uric acid level as potential biomarker for dementia.Relevance: The information gained from this study will enable us to diagnose dementia in the early stages and improve thequality of life of the patients.
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Objective To investigate the effect of preoperative serum uric acid level on the incidence of acute kidney in-jury after off-pump coronary artery bypass grafting and to discuss whether serum uric acid level is an independent predictor of postoperative acute kidney injury.Methods A total of 631 patients undergoing off-pump coronary artery bypass grafting in Anzhen Hospital from January 2018 to June 2018 were reviewed.Patients were divided into high uric acid group(higher-than-median)and low uric acid group(lower-than-median) , based on the preoperative serum uric acid level of the patients.The de-mographic variables, comorbidities, the chelsea comorbidity index, preoperative medication, serum creatinine level and glo-merular filtration rate were compared between the two groups.Meanwhile, intraoperative operative time, infusion volume, post-operative acute kidney injury staging and the rate of frozen plasma usage , continuous renal replacement therapy and reoperation rate were observed.Results Among the 631 patients, 83(13.2％, 83/631)cases developed postoperative acute kidney inju-ry, 65(78.3％, 65/83) cases had a higher level of preoperative serum uric acid above the median(OR =3.143, 95％CI:1.850-8.798, P=0.001).After adjustment, multivariate analysis showed that elevated level of serum uric acid and BMI >30 kg/m2, the increase of preoperative serum creatinine level, the decrease of glomerular filtration rate( <60 ml/min) and higher CCI score were associated with postoperative acute kidney injury independently .Intraoperative fluid volume , diabetes and preoperative diuretic administration did not relate to the incidence of acute kidney injury after cardiac surgery .Conclusion Elevated serum uric acid level can be a strong predictor for the incidence of acute kidney injury after off-pump coronary artery bypass grafting.
ABSTRACT
The debate over the clinical meaning of plasma uric acid level is still a very hot issue. As the interest in health grows larger in the general public, the number of having a regular health check-up is increasing rapidly. Most of the health care centers routinely check the plasma uric acid level but it is not simple to interpret and explain the appropriate meaning of that. Over the past decade, there have been several studies on clinical implication of plasma uric acid level but the question still remains. However the clinical significance of the results might be different according to the severity of cardiovascular risk among subjects studied, and the findings for correlation with the established risks have enough proof to be applied to clinical practice. Additionally, the uric acid-lowering agents should not be used in general population even though it has reason to be prescribed in a specific high risk patient. Thus, this review seeks to be helpful in clinical practice by examining the preexisting related studies in a different perspective.