Role of serum uric acid in acute myocardial infarction as a prognostic marker, in a tertiary care center of South-Eastern Rajasthan

Abstract

Introduction: Myocardial infarction (MI) is a leading cause of death worldwide, and myocardial cell death is associated with increased uric acid production. Therefore, in the underlying tissue death, the increased uric acid level can be used as a prognostic marker in MI, concerning Killip’s classification. Materials and Methods: Our study included 100 diagnosed cases of acute MI with 100 controls admitted to SRG Hospital, Jhalawar, Rajasthan, India. A meticulous clinical history and physical examination with special reference to the Killip class were carried out. All the routine investigations, including complete blood count, renal function test, liver function test, electrocardiogram, cardiac markers, and chest X-ray, were done on admission. Serum uric acid levels were measured on days 0, 3, and 7 of MI. Hyperuricemia is labeled in our study for males >7 mg/dL and females >5 mg/dL. Results: Our study included 63 males and 37 females as cases. On admission, we found statistically significant elevated levels of uric acid in patients with acute MI compared with controls. The higher Killip class patients had higher uric acid levels on days 0, 3, and 7, irrespective of their sex and history of hypertension and diabetes mellitus. During our study, four patients died within 5 days of admission and had higher serum uric acid levels, that is, >7 mg/dL, and all of them were included in Killip class IV, irrespective of sex. Conclusion: Patients of acute MI with higher Killip class had elevated serum uric acid levels. The serum uric acid levels correlate with the Killip class and are an evident predictor of mortality and morbidity after acute MI.

Keywords

• hyperuricemia
• killip class
• myocardial infarction