Prevalence and Determinants of Hyperuricemia in South Indian Adult Patients with Stable Coronary Artery Disease

Abstract

Background: There is paucity of studies on the prevalence of hyperuricemia in Indian patients with coronary artery disease (CAD). Population differences have been observed in both the prevalence and relationship of hyperuricemia with CAD risk factors in previous studies. Objectives: Our study objectives were to analyze the prevalence and determinants of hyperuricemia in south Indian patients with stable and angiographic evidence of CAD. Methods: Study subjects were 520 patients with stable CAD. Severity of CAD was assessed by estimating the Gensini score. Patients in heart failure, those who had a recent myocardial infarction (< 7 days ), or liver disease or impaired renal function (GFR < 30ml/min), and those with hematological or oncological disorders were excluded from the study. Medical and dietitic history, clinical and laboratory data of patients were recorded. Hyperuricemia was diagnosed based on cut off values of ≥7mg/dl of serum uric acid in men and ≥ 6.5 mg/dl of serum uric acid in women. Results: Hyperuricemia was present in 242 patients (46.5%; 95% CI : 42.29-50.84%). A significant association (P < 0.001) was seen between hyperuricemia and consumption of a diet which could influence serum uric acid levels as well as history of regular alcohol consumption. There was no statistically significant association between hyperuricemia and intake of diuretics, presence of either diabetes or hypertension and serum cholesterol levels. Serum triglyceride levels were significantly more in those with hyperuricemia than in those with normal serum uric acid levels (P 0.03). There was no correlation between serum uric acid levels and presence or absence of urinary calculi. The mean Gensini score was 22.57 ± 9.99 in patients with hyperuricemia (n = 242) and the score was 9.42 ± 4.77 in those with normal serum uric acid levels (n = 278). This significant difference (P < 0.001) between the two groups indicate a more severe degree of severity of CAD in patients with hyperuricemia. Conclusion: Our study indicates a high prevalence of hyperuricemia in south Indian patients with stable CAD and that hyperuricemia is associated with severity of CAD, though it does not correlate with conventional risk factors such as diabetes, hypertension and elevated cholesterol levels.

Keywords

• cardiovascular disease
• coronary artery disease
• hyperuricemia