Uric Acid is not an independent predictor of cardiovascular death in patients with angiographically proven coronary artery disease.

BACKGROUND The aim of this study is to investigate the impact of uric acid on clinical outcomes in patients with angiographically proven coronary artery disease. METHOD Six hundred and forty seven consecutive patients with angiographically proven significant coronary artery disease were enrolled in this retrospective study. Patients were assigned to serum uric acid level >or= 6.4 mg/dL and < 6.4 mg/dL groups based on baseline fasting uric acid levels and determined by a receiver operating characteristic curve. The mean follow-up duration was 4.6 +/- 1.1 years after coronary angiography. The primary endpoints were all cause mortality and death from cardiovascular disease. RESULTS The five-year survival rates for patients free from all-cause mortality with levels of uric acid >or= 6.4 mg/dL and < 6.4 mg/dL were 82% and 92% respectively (p < 0.0001). Five-year survival rates for patients free from cardiovascular mortality with levels of uric acid uric acid >or= 6.4 mg/dL and < 6.4 mg/dL were 91% and 97% respectively (p = 0.003). Multivariate Cox regression analysis showed that serum uric acid was an independent predictor of all-cause death (p = 0.01) but was not an independent predictor of cardiovascular mortality (p = 0.063) after adjusting for multi-vessel coronary artery disease, chronic renal insufficiency and a left ventricular ejection fraction < 40%. CONCLUSIONS After multivariate adjustment, the fasting serum uric acid level was an independent predictor of all-cause mortality, but probably not an independent predictor of cardiovascular mortality in patients with angiographically proven coronary artery disease.