The following is a summary of “Association of serum uric acid with prognosis in patients with myocardial infarction: an update systematic review and meta-analysis,” published in the October 2023 issue of Cardiology by Huang et al.
The role of serum uric acid (SUA) in predicting prognosis after myocardial infarction (MI) is still debated. Researchers conducted a retrospective study to assess immediate and long-term adverse outcomes in MI patients with elevated uric acid (UA) levels.
They started a systematic review and meta-analysis by searching the literature in PubMed, Embase, Web of Science, Medline, Cochrane Library, Emcrae, and Scopus to assess the prognostic impact of MI with elevated SUA. This included the evaluation of short-term (30-day or in-hospital) and long-term mortality, the incidence of major adverse cardiovascular events (MACE), and the adverse event rate associated with SUA. The literature search encompassed data up to April 2023. Epidemiological indicators, such as RR, were analyzed using a random effects model. RRs were treated as ORs for low-rate hands, and HRs and ORs were adjusted for confounding factors. P values for original hypotheses were used in a meta-analysis. High SUA was defined as ≥ 420 μmol/L (7.0 mg/dL) in men and ≥ 357 μmol/L (6.0 mg/dL) in women. The quality of the literature was investigated using the Newcastle–Ottawa Scale (NOS).
The results showed 41 investigations and a substantial sample size of 225,600 individuals with a history of MI. The meta-analysis showed that individuals diagnosed with hyperuricemia had notably elevated short-term mortality rates (RR = 2.14, 95% CI = 1.86, 2.48) and short-term MACE incidence (RR = 1.94, 95% CI = 1.65–2.11). This specific patient population had notably higher long-term adverse outcomes, including all-cause mortality (RR = 1.46, 95% CI = 1.40–1.51) and MACE incidence (RR = 1.43, 95% CI = 1.35–1.52).
They concluded that patients with heart attacks and high UA levels have a higher risk of dying in the hospital or within one year of discharge.