Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study-Reference-Cited by-同舟云学术

Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study

Published:2023-02-07 Issue:2 Volume:13 Page:244
ISSN:2218-1989
Container-title:Metabolites
language:en
Short-container-title:Metabolites

Author:

Mengozzi Alessandro¹²³^ORCID,Pugliese Nicola Riccardo¹^ORCID,Desideri Giovambattista⁴^ORCID,Masi Stefano¹^ORCID,Angeli Fabio⁵⁶^ORCID,Barbagallo Carlo Maria⁷^ORCID,Bombelli Michele⁸,Cappelli Federica¹,Casiglia Edoardo⁹^ORCID,Cianci Rosario¹⁰,Ciccarelli Michele¹¹^ORCID,Cicero Arrigo F. G.¹²¹³^ORCID,Cirillo Massimo¹⁴^ORCID,Cirillo Pietro¹⁵,Dell’Oro Raffaella⁸,D’Elia Lanfranco¹⁶^ORCID,Ferri Claudio⁴,Galletti Ferruccio¹⁶,Gesualdo Loreto¹⁵^ORCID,Giannattasio Cristina¹⁷¹⁸,Grassi Guido⁸,Iaccarino Guido¹¹,Lippa Luciano¹⁹^ORCID,Mallamaci Francesca²⁰,Maloberti Alessandro¹⁷¹⁸^ORCID,Masulli Maria¹⁶,Mazza Alberto²¹,Muiesan Maria Lorenza²²^ORCID,Nazzaro Pietro²³,Palatini Paolo⁹^ORCID,Parati Gianfranco²⁴^ORCID,Pontremoli Roberto²⁵^ORCID,Quarti-Trevano Fosca⁸^ORCID,Rattazzi Marcello²⁶,Reboldi Gianpaolo²⁷^ORCID,Rivasi Giulia²⁸^ORCID,Russo Elisa²⁵^ORCID,Salvetti Massimo²²^ORCID,Tikhonoff Valerie²⁹^ORCID,Tocci Giuliano³⁰^ORCID,Ungar Andrea²⁸,Verdecchia Paolo³¹,Viazzi Francesca²⁵^ORCID,Volpe Massimo³⁰,Borghi Claudio¹²¹³^ORCID,Virdis Agostino¹^ORCID

Affiliation:

1. Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy

2. Center for Translational and Experimental Cardiology (CTEC), Department of Cardiology, University Hospital Zurich, University of Zurich, 8952 Schlieren, Switzerland

3. Scuola Superiore Sant’Anna, 56127 Pisa, Italy

4. Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy

5. Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy

6. Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS Tradate, 21100 Varese, Italy

7. Biomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, Italy

8. Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy

9. Studium Patavinum, Department of Medicine, University of Padua, 35100 Padua, Italy

10. Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy

11. Department of Advanced Biomedical Sciences, “Federico II” University of Naples, 80133 Naples, Italy

12. Department Hypertension and Cardiovascular Disease Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy

13. Heart-Chest-Vascular Department, IRCCS AOU of Bologna, 40126 Bologna, Italy

14. Department of Public Health, “Federico II” University of Naples, 80133 Naples, Italy

15. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, Italy

16. Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80133 Naples, Italy

17. Cardiology IV, “A.De Gasperi’s” Department, Niguarda Ca’ Granda Hospital, 20162 Milan, Italy

18. School of Medicine and Surgery, Milano-Bicocca University, 20126 Milan, Italy

19. Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy

20. CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, 89124 Reggio Calabria, Italy

21. Department of Internal Medicine, Santa Maria Della Misericordia General Hospital, AULSS 5 Polesana, 45100 Rovigo, Italy

22. Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy

23. Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Neurosciences and Sense Organs, University of Bari Medical School, 70122 Bari, Italy

24. S. Luca Hospital, Istituto Auxologico Italiano & University of Milan-Bicocca, 20126 Milan, Italy

25. Department of Internal Medicine, University of Genoa; IRCSS Ospedale Policlinico San Martino, 16132 Genova, Italy

26. Department of Medicine—DIMED, University of Padova, Medicina Interna 1°, Ca’ Foncello University Hospital, 31100 Treviso, Italy

27. Department of Medical and Surgical Science, University of Perugia, 06100 Perugia, Italy

28. Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy

29. Department of Medicine, University of Padua, 35100 Padua, Italy

30. Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy

31. Hospital S. Maria della Misericordia, 06100 Perugia, Italy

Abstract

High serum uric acid (SUA) and triglyceride (TG) levels might promote high-cardiovascular risk phenotypes across the cardiometabolic spectrum. However, SUA predictive power in the presence of normal and high TG levels has never been investigated. We included 8124 patients from the URic acid Right for heArt Health (URRAH) study cohort who were followed for over 20 years and had no established cardiovascular disease or uncontrolled metabolic disease. All-cause mortality (ACM) and cardiovascular mortality (CVM) were explored by the Kaplan–Meier estimator and Cox multivariable regression, adopting recently defined SUA cut-offs for ACM (≥4.7 mg/dL) and CVM (≥5.6 mg/dL). Exploratory analysis across cardiometabolic subgroups and a sensitivity analysis using SUA/serum creatinine were performed as validation. SUA predicted ACM (HR 1.25 [1.12–1.40], p < 0.001) and CVM (1.31 [1.11–1.74], p < 0.001) in the whole study population, and according to TG strata: ACM in normotriglyceridemia (HR 1.26 [1.12–1.43], p < 0.001) and hypertriglyceridemia (1.31 [1.02–1.68], p = 0.033), and CVM in normotriglyceridemia (HR 1.46 [1.23–1.73], p < 0.001) and hypertriglyceridemia (HR 1.31 [0.99–1.64], p = 0.060). Exploratory and sensitivity analyses confirmed our findings, suggesting a substantial role of SUA in normotriglyceridemia and hypertriglyceridemia. In conclusion, we report that SUA can predict ACM and CVM in cardiometabolic patients without established cardiovascular disease, independent of TG levels.

Funder

Italian Society of Arterial Hypertension

Publisher

MDPI AG

Subject

Molecular Biology,Biochemistry,Endocrinology, Diabetes and Metabolism

Link

https://www.mdpi.com/2218-1989/13/2/244/pdf

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