Frontiers in Cardiovascular Medicine (Feb 2023)

Sex differences between serum uric acid levels and cardiovascular outcomes in patients with coronary artery disease after stent implantation

  • Song Lin Yuan,
  • Moo Hyun Kim,
  • Kwang Min Lee,
  • Xuan Jin,
  • Zhao Yan Song,
  • Jong-Sung Park,
  • Young-Rak Cho,
  • Kyunghee Lim,
  • Sung-Cheol Yun

DOI
https://doi.org/10.3389/fcvm.2023.1021277
Journal volume & issue
Vol. 10

Abstract

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BackgroundThe relationship between elevated serum uric acid (SUA) levels and cardiovascular outcomes after stent implantation remains uncertain. This study sought to evaluate the impact of SUA on 12-month cardiovascular outcomes after stent implantation.MethodsWe performed a retrospective study of patients who successfully underwent stent implantation and enrolled 3,222 patients with coronary artery disease (CAD) from a single center. SUA levels were measured before stent implantation. The patients were divided into six groups (<4, 4–4.9, 5–5.9, 6–6.9, 7–7.9 and ≥ 8 mg/dL) at SUA intervals of 1.0 mg/dL. The incidence of cardiovascular outcomes in the six groups was monitored for 1 year after stent implantation and the hazard ratios were estimated. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for cardiovascular outcomes were estimated using a Cox proportional hazard regression analysis. The primary endpoint was all-cause death. The secondary endpoint was a composite of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis and stroke. The follow-up duration was 12 months.ResultsOver the 12-month follow-up period, there were 101 all-cause deaths and 218 MACCE. After adjustment for several parameters, the group with SUA levels of more than or equal to 8 mg/dL had significantly higher hazard ratios in the incidence of all-cause death or MACCE. The group with <4.0 mg/dL had significantly higher hazard ratios in all-cause death only in male patients. In contrast, there were no significant differences observed for cardiovascular outcomes in female patients.ConclusionsOur study identified a U-shaped association between SUA levels and cardiovascular outcomes during 12-month follow-up for males, but not for females. Further studies are warranted to clarify the sex differences between SUA levels and clinical outcomes.

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