Heart Vessels. 2026 Apr 29. doi: 10.1007/s00380-026-02685-0. Online ahead of print.
ABSTRACT
Patients with hyperuricemia may have an elevated risk of cardiovascular events. Owing to the relationship between uric acid (UA) levels and renal function, the impact of hyperuricemia may differ depending on the presence or absence of renal dysfunction. This study aimed to evaluate the impact of hyperuricemia on cardiac events in coronary artery disease (CAD) patients with or without renal dysfunction. This single-center observational study enrolled patients with stable CAD who underwent percutaneous coronary intervention. Hyperuricemia (high UA) was defined as a UA level ≥ 7 mg/dL according to guideline criteria. The high- and low-UA groups were compared separately in patients with and without renal dysfunction, defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2. The primary endpoint was the occurrence of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and hospitalization for heart failure. Overall, 1169 patients were included, with a mean age of 69.9 ± 9.8 years; 80.3% were male. Hyperuricemia was present in 10.2% of patients without renal dysfunction (n = 616) and 32.0% of those with renal dysfunction (n = 553). The median follow-up period was 5.0 years (interquartile range: 2.1-8.6 years). Among patients without renal dysfunction, no significant difference was observed in MACE occurrence between the high- and low-UA groups (log-rank p = 0.19). In contrast, among patients with renal dysfunction, the incidence of MACE was higher in the high-UA group than in the low-UA group (log-rank p = 0.003). However, multivariable analyses indicated that high UA was not an independent predictor of MACE, even among patients with renal dysfunction. Hyperuricemia may serve as a useful marker for cardiac events, with a more apparent association in patients with renal dysfunction; however, UA itself may not have a direct causal role.
PMID:42050272 | DOI:10.1007/s00380-026-02685-0