Association of Serum Uric Acid Level with Short Term In-Hospital Mortality In St-Elevation Myocardial Infarction

Authors

  • Muhammad Ismail Department of Medicine, Armed Forces Institute of Radiology & Imaging Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Asad Mahmood Department of Medicine, Armed Forces Institute of Radiology & Imaging Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Zubair Ahmed Department of Medicine, Armed Forces Institute of Radiology & Imaging Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Ishtiaq Munir Janjua Department of Medicine, Armed Forces Institute of Radiology & Imaging Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Syed Fahad Ul Hassan Department of Medicine, Armed Forces Institute of Radiology & Imaging Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Naveed Department of Medicine, Armed Forces Institute of Radiology & Imaging Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.13175

Keywords:

In-hospital mortality, Serum uric acid level, ST elevation myocardial infarction

Abstract

Objective: To determine the relationship between elevated blood uric acid levels and short-term in-hospital mortality in myocardial infarction with ST-elevation.

Study Design: Quasi-experimental.

Place and Duration of Study: Combined Military Hospital (CMH), Hyderabad, Pakistan from Aug to Dec 2023.

Methodology: A total of 378 (189 in each group) patients were enrolled, and serum uric acid sample was sent for analysis, patients were monitored for seven days after admission. Patients were split into two groups based on their serum uric acid levels: Group A (exposed) and Group B (non-exposed), identical treatment was given to both groups. Baseline investigations were carried out on admission including ECG, blood complete picture, coagulation profile, cardiac enzymes, lipid profile, chest X-ray, renal and liver function tests and troponins.

Results: Group A (high serum uric acid, 10%) had a greater mortality rate than Group B (low serum uric acid, 3%) and significant categories with higher death rates were patients with history of smoking (75.0%, p = 0.029), hypertension (77.8%, p = 0.010), BMI ≤ 25 kg/m² (78.6%, p = 0.033), and men (76.5%, p = 0.026). Results point to serum uric acid as a prognostic biomarker, highlighting its function in risk assessment for treatment of ST-Segment Elevation Myocardial Infarction (STEMI).

Conclusions: Elevated serum uric acid level was noted to be linked to a higher in-hospital death rate among patients with ST elevation myocardial infarction.

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References

1. Mandurino-Mirizzi A, Cornara S, Somaschini A, Demarchi A, Galazzi M, Puccio S, et al. Elevated serum uric acid is associated with a greater inflammatory response and with short- and long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Nutr Metab Cardiovasc Dis 2021; 31(2): 608-614.

https://doi.org/10.1016/j.numecd.2020.10.020

2. Copur S, Demiray A, Kanbay M. Uric acid in metabolic syndrome: Does uric acid have a definitive role? Eur J Intern Med 2022; 103: 4-12.

https://doi.org/10.1016/j.ejim.2022.04.022

3. Aslam F, Maqsood A, Rauf A, Nawaz K, Aslam A. Frequency of risk factors for stroke in young Pakistani population. Pak J Neurol Sci 2023; 18(4): 352-358.

https://doi.org/10.56310/pjns.v18i04.294

4. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol 2020; 76(25): 2982-3021.

https://doi.org/10.1016/j.jacc.2020.11.010

5. Hassan FU, Ahmed I, Shah NA, Tariq F, Shah JA, Afaq S. Association of serum uric acid level with short term in-hospital mortality in ST-elevation myocardial infarction. Pak Armed Forces Med J 2020; 70(3): 644-648.

6. Uddin M, Mir T, Khalil A, Mehar A, Gomez-Pineiro E, et al. ST-elevation myocardial infarction outcomes: A United States nationwide emergency departments cohort study. J Emerg Med 2022; 62(3): 306-315.

https://doi.org/10.1016/j.jemermed.2021.10.028

7. Gherghina ME, Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA. Uric acid and oxidative stress—relationship with cardiovascular, metabolic, and renal impairment. Int J Mol Sci 2022; 23(6): 3188.

https://doi.org/10.3390/ijms23063188

8. Li K, Li K, Yao Q, Shui X, Zheng J, He Y, et al. The potential relationship of coronary artery disease and hyperuricemia: A cardiometabolic risk factor. Heliyon 2023; 9(5): e16097.

https://doi.org/10.1016/j.heliyon.2023.e16097

9. Haghaninejad H, Banifatemeh SA, Mohammadi H, Ratki SK, Moghadam RN, et al. The role of serum uric acid in predicting left ventricular function and outcomes in patients with STEMI following PCI. Cardiovasc Biomed J 2024; 4(1): 39-47.

https://doi.org/10.18502/cbj.v4i1.16226

10. Rong J, Fang C, Chen X, Hong C, Huang L. Association of serum uric acid with prognosis in patients with myocardial infarction: An updated systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23(1): 512.

https://doi.org/10.1186/s12872-023-03523-1

11. Timóteo AT, Lousinha A, Labandeiro J, Miranda F, et al. Serum uric acid, a forgotten prognostic marker in acute coronary syndromes? Eur Heart J Acute Cardiovasc Care 2013; 2(1): 44-52.

https://doi.org/10.1177/2048872612474921

12. Młynarska E, Czarnik W, Fularski P, Hajdys J, et al. From atherosclerotic plaque to myocardial infarction—The leading cause of coronary artery occlusion. Int J Mol Sci 2024; 25(13): 7295.

https://doi.org/10.3390/ijms25137295

13. Rebora P, Centola M, Morici N, Sacco A, Occhino G, et al. Uric acid associated with acute heart failure presentation in acute coronary syndrome patients. Eur J Intern Med 2022; 99: 30-37.

https://doi.org/10.1016/j.ejim.2022.01.018

14. Cho SK, Chang Y, Kim I, Ryu S. U-shaped association between serum uric acid level and risk of mortality: A cohort study. Arthritis Rheumatol 2018; 70(7): 1122-1132.

https://doi.org/10.1002/art.40472

15. Li L, Ma Y, Shang XM, Hong Y, Wang JH, et al. Hyperuricemia is associated with short-term outcomes in elderly patients with acute myocardial infarction. Aging Clin Exp Res 2018; 30(10): 1211-1215.

https://doi.org/10.1007/s40520-018-0903-3

16. Centola M, Maloberti A, Castini D, Persampieri S, et al. Impact of admission serum uric acid levels on in-hospital outcomes in patients with acute coronary syndrome. Eur J Intern Med 2020; 82: 62-67.

https://doi.org/10.1016/j.ejim.2020.07.013

17. Otaki Y, Konta T, Ichikawa K, Fujimoto S, et al. Possible burden of hyperuricaemia on mortality in a community-based population: A large-scale cohort study. Sci Rep 2021; 11(1): 8999.

https://doi.org/10.1038/s41598-021-88631-8

18. Lopez-Pineda A, Cordero A, Carratala-Munuera C, Orozco-Beltran D, et al. Hyperuricemia as a prognostic factor after acute coronary syndrome. Atherosclerosis 2018; 269: 229-235.

https://doi.org/10.1016/j.atherosclerosis.2018.01.017

19. Xu Q, Zhang M, Abeysekera IR, Wang X. High serum uric acid levels may increase mortality and major adverse cardiovascular events in patients with acute myocardial infarction. Saudi Med J 2017; 38(6): 577-582.

https://doi.org/10.15537/smj.2017.6.17190

20. Lazzeri C, Valente S, Chiostri M, Gensini GF. Long-term prognostic role of uric acid in patients with ST-elevation myocardial infarction and renal dysfunction. J Cardiovasc Med (Hagerstown) 2015; 16(11): 790-794.

https://doi.org/10.2459/JCM.0000000000000238

21. Virdis A, Masi S, Casiglia E, Tikhonoff V, et al. Identification of the uric acid thresholds predicting an increased total and cardiovascular mortality over 20 years. Hypertension 2020; 75(2): 302-308.

https://doi.org/10.1161/HYPERTENSIONAHA.119.13643

22. Behera SK, Samal AK. Study of serum uric acid level as a prognostic marker in acute ST elevation myocardial infarction patients. Int J Adv Med 2018; 5(4): 945-949.

https://doi.org/10.18203/2349-3933.ijam20182108

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Published

30-01-2026

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How to Cite

1.
Ismail M, Mahmood A, Zubair Ahmed, Janjua IM, Ul Hassan SF, Naveed M. Association of Serum Uric Acid Level with Short Term In-Hospital Mortality In St-Elevation Myocardial Infarction. Pak Armed Forces Med J [Internet]. 2026 Jan. 30 [cited 2026 Feb. 6];76(SUPPL-1):S131-S135. Available from: https://www.pafmj.org/PAFMJ/article/view/13175