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The interaction between hyperuricemia and low-density lipoprotein cholesterol increases the risk of 1-year post-discharge all-cause mortality in ST-segment elevation myocardial infarction patients
Affiliation:1. Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;2. Department of Cardiac Care Unit, The First Affiliated Hospital of Wenzhou Medical University Wenzhou, China
Abstract:Background and aimsHyperuricemia is a known risk factor for cardiovascular diseases, but little is known on whether the association between hyperuricemia and poor outcomes in ST-segment elevation myocardial infarction (STEMI) is modified by low-density lipoprotein cholesterol (LDL-c). This study aimed to investigate the effect of the interaction between hyperuricemia and LDL-c on the risk of 1-year post-discharge all-cause mortality in STEMI patients.Methods and resultsA total of 1396 STEMI patients were included. Cox proportional hazards models were used to determine the association between hyperuricemia and 1-year all-cause mortality in the overall population and subgroups stratified based on LDL-c levels (<3.0 mmol/L or ≥3.0 mmol/L). Multivariate analysis indicated that hyperuricemia was associated with 1-year mortality (HR: 2.66; 95% CI: 1.30–5.47; p = 0.008). However, the prognostic effect of hyperuricemia was only observed in patients with LDL-c level ≥3.0 mmol/L (HR: 12.90; 95% CI: 2.98–55.77; p < 0.001), but not in those with LDL-c level <3.0 mmol/L (HR: 0.91, 95% CI: 0.30–2.79, p = 0.875). The interaction between hyperuricemia and LDL-c levels had a significant effect on 1-year mortality.ConclusionHyperuricemia was associated with increased 1-year post-discharge mortality in patients with LDL-c level≥ 3.0 mmol/L, but not in those with LDL-c level< 3.0 mmol/L.
Keywords:Uric acid  Hyperuricemia  Low-density lipoprotein cholesterol  Myocardial infarction  Mortality  Interaction  CAD"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0045"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  coronary artery disease  ACS"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0055"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  acute coronary syndrome  STEMI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0065"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  ST-segment elevation myocardial infarction  SUA"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0075"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  Serum uric acid  CCU"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0085"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  cardiac care unit  HRs"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0095"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  hazard ratios  CI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0105"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  confidence interval  PPCI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0115"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  primary percutaneous coronary intervention  CABG"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0125"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  coronary artery bypass grafting  SBP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0135"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  systolic blood pressure  DBP"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0145"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  diastolic blood pressure  EGFR"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0155"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  estimated glomerular filtration rate  HDL-c"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0165"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  high-density lipoprotein cholesterol  LDL-c"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0175"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  low-density lipoprotein cholesterol  Hs-cTnI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0185"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  high-sensitivity troponin I  ACEI"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0195"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  angiotensin-converting enzyme inhibitor  ARB"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0205"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  angiotensin receptor blocker  XOR"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0215"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  xanthine oxidoreductase  MACE"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0225"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  major adverse cardiac events  sdLDL-c"  },{"  #name"  :"  keyword"  ,"  $"  :{"  id"  :"  kwrd0235"  },"  $$"  :[{"  #name"  :"  text"  ,"  _"  :"  small dense low-density lipoprotein-cholesterol
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