Hyperuricemia in Acute Coronary Syndrome Patients at Tertiary Care Hospital Peshawar.

Authors

  • Shabina Shafiullah Peshawar Medical College Peshawar
  • Muhammad Abbas Peshawar Medical College Prime Teaching Hospital
  • Muhammad Abdur Rauf Peshawar Medical College Peshawar
  • Syed Tahir Shah Peshawar Medical College Kuwait Teaching Hospital
  • Muhammad Saleem Awan Ayub Medical College/Ayub Teaching Hospital Abbottabad
  • Muhammad Ziyad Peshawar Medical College Kuwait Teaching Hospital

DOI:

https://doi.org/10.35845/abms.2024.1.345

Abstract

Objective

To investigate the affiliation between elevated uric acid and acute coronary syndrome.

Methods

This descriptive cross-sectional study was conducted over twelve months from June 2022 to May 2023 in the Cardiac Care Unit (CCU) and Pathology Laboratory of Kuwait Teaching Hospital. 201 patients were included, determined using the WHO sample size calculator. Inclusion criteria were patients with typical ischemic chest pain indicative of ACS, irrespective of gender and age, who were willing to participate. Data were collected using a structured preform questionnaire covering demographics, medical history, clinical presentation, and diagnostic findings. Key data included patient age, gender, history of hypertension, diabetes, hyperlipidemia, smoking status, family history of coronary artery disease, and symptoms at presentation. ACS was classified into STEMI, NSTEMI, or Unstable Angina based on ECG and troponin-I levels. Serum uric acid levels were measured after an eight-hour fasting period. Data were entered into Microsoft Excel and analyzed using SPSS version 25, employing descriptive statistics and Chi-square tests, with a p-value of <0.05 considered significant.

Results

A total 201 study participants were enrolled (average age: 57.5 years), with 99 (49%) males. Diabetes mellitus was found in 88 (44% of patients) and hypertension in 83 (41%). In 73 (36%) of the patients, hyperuricemia was seen. Males were more likely to have hyperuricemia (75%) than females 60 (59%), and diabetics were more likely to have it (80%) than hypertensive people 59 (71%). The overall incidence of hyperuricemia in ACS patients was 52%.

Conclusion

Our findings demonstrate the high prevalence of hyperuricemia in persons diagnosed with acute coronary syndrome. Routine monitoring and surveillance of blood uric acid levels in the general population appears to be a viable technique for proactively identifying and addressing anomalies promptly.

References

Marak AF, Thongam N, Hijam D, Devi OP, Singh SR, Ng T. Serum Uric Acid in Acute Coronary Syndromes. heart failure (CHF). 2019;4(5):6-7.

Pollack Jr CV, Riese VG. Acute Coronary Syndrome: Non–ST-Segment Elevation Myocardial Infarction. Differential Diagnosis of Cardiopulmonary Disease: A Handbook. 2019:11-41.

Ranjith N, Myeni NN, Sartorius B, Mayise C. Association between hyperuricemia and major adverse cardiac events in patients with acute myocardial infarction. Metabolic syndrome and related disorders. 2017 Feb 1;15(1):18-25.

Ndrepepa G, Braun S, Haase HU, Schulz S, Ranftl S, Hadamitzky M, Mehilli J, Schömig A, Kastrati A. Prognostic value of uric acid in patients with acute coronary syndromes. The American journal of cardiology. 2012 May 1;109(9):1260-5.

Duran M, Kalay N, Akpek M, Orscelik O, Elcik D, Ocak A, Inanc MT, Kasapkara HA, Oguzhan A, Eryol NK, Ergin A. High levels of serum uric acid predict severity of coronary artery disease in patients with acute coronary syndrome. Angiology. 2012 Aug;63(6):448-52.

Atar Aİ, Yılmaz ÖÇ, Akın K, Selçoki Y, Er O, Eryonucu B. Serum uric acid level is an independent risk factor for presence of calcium in coronary arteries: an observational case-controlled study. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2013 Mar 1;13(2).

Kim H, Kim SH, Choi AR, Kim S, Choi HY, Kim HJ, Park HC. Asymptomatic hyperuricemia is independently associated with coronary artery calcification in the absence of overt coronary artery disease: a single-center cross-sectional study. Medicine. 2017 Apr 1;96(14):e6565.

Neogi T, Terkeltaub R, Ellison RC, Hunt S, Zhang Y. Serum urate is not associated with coronary artery calcification: the NHLBI Family Heart Study. The Journal of rheumatology. 2011 Jan 1;38(1):111-7.

Tian TT, Li H, Chen SJ, Wang Q, Tian QW, Zhang BB, Zhu J, He GW, Lun LM, Xuan C. Serum Uric Acid as an Independent Risk Factor for the Presence and Severity of Early‐Onset Coronary Artery Disease: A Case‐Control Study. Disease markers. 2018;2018(1):1236837.

Maiuolo J, Oppedisano F, Gratteri S, Muscoli C, Mollace V. Regulation of uric acid metabolism and excretion. International journal of cardiology. 2016 Jun 15;213:8-14.

Jin M, Yang F, Yang I, Yin Y, Luo JJ, Wang H, Yang XF. Uric acid, hyperuricemia and vascular diseases. Frontiers in bioscience: a journal and virtual library. 2012 Jan 1;17:656.

Goodarzynejad H, Anvari MS, Boroumand MA, Karimi A, Abbasi SH, Davoodi G. Hyperuricemia and the presence and severity of coronary artery disease. Laboratory Medicine. 2010 Jan 1;41(1):40-5.

Proctor PH. Uric acid: neuroprotective or neurotoxic?. Stroke. 2008 May 1;39(5):e88-.

Manzano L, Babalis D, Roughton M, Shibata M, Anker SD, Ghio S, van Veldhuisen DJ, Cohen‐Solal A, Coats AJ, Poole‐Wilson PP, Flather MD. Predictors of clinical outcomes in elderly patients with heart failure. European journal of heart failure. 2011 May;13(5):528-36.

Chen L, Li XL, Qiao W, Ying Z, Qin YL, Wang Y, Zeng YJ, Ke YN. Serum uric acid in patients with acute ST-elevation myocardial infarction. World Journal of Emergency Medicine. 2012;3(1):35.

Qudwai W, Jawaid M. Frequency of uric acid levels symptomatic and asymptomatic hyperuricemia among the Pakistani population. Mid East J Fam Med. 2017 Sep 1;15:52-7.

Raja S, Kumar A, Aahooja RD, Thakuria U, Ochani S, Shaukat F. Frequency of hyperuricemia and its risk factors in the adult population. Cureus. 2019 Mar 6;11(3).

Daniel WW. Biostatistics: a foundation for analysis in the health sciences. Wiley; 1978.

Lopez-Pineda A, Cordero A, Carratala-Munuera C, Orozco-Beltran D, Quesada JA, Bertomeu-Gonzalez V, Gil-Guillen VF, Bertomeu-Martinez V. Hyperuricemia as a prognostic factor after acute coronary syndrome. Atherosclerosis. 2018 Feb 1;269:229-35.

Tiong AY, Brieger D. Inflammation and coronary artery disease. American heart journal. 2005 Jul 1;150(1):11-8.

Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 2006 Aug;54(8):2688-96.

Bhattacharya PK, Agarwal M, Gautom D, Saikia H. Role of serum uric acid level in predicting outcome in acute myocardial infarction. Natl J Lab Med. 2016;5(4):18-22.

Fromonot J, Deharo P, Bruzzese L, Cuisset T, Quilici J, Bonatti S, Fenouillet E, Mottola G, Ruf J, Guieu R. Adenosine plasma level correlates with homocysteine and uric acid concentrations in patients with coronary artery disease. Canadian Journal of Physiology and Pharmacology. 2016;94(3):272-7.

Duran M, Kalay N, Akpek M, Orscelik O, Elcik D, Ocak A, Inanc MT, Kasapkara HA, Oguzhan A, Eryol NK, Ergin A. High levels of serum uric acid predict severity of coronary artery disease in patients with acute coronary syndrome. Angiology. 2012 Aug;63(6):448-52.

Barbieri L, Verdoia M, Schaffer A, Marino P, Suryapranata H, De Luca G, Novara Atherosclerosis Study Group. Impact of sex on uric acid levels and its relationship with the extent of coronary artery disease: A single-centre study. Atherosclerosis. 2015 Jul 1;241(1):241-8.

Published

2024-06-21

How to Cite

Shabina Shafiullah, Muhammad Abbas, Muhammad Abdur Rauf, Syed Tahir Shah, Muhammad Saleem Awan, & Muhammad Ziyad. (2024). Hyperuricemia in Acute Coronary Syndrome Patients at Tertiary Care Hospital Peshawar. ADVANCES IN BASIC MEDICAL SCIENCES, 8(1), 44–48. https://doi.org/10.35845/abms.2024.1.345