FREQUENCY OF HYPERURICEMIA IN SUBJECTS WITH UNSTABLE ANGINA/MYOCARDIAL INFARCTION AND THEIR PROGNOSIS

Abstract

Background: Suppression of nitric oxide synthesis and stimulation of smooth muscle proliferation by increased serum levels of uric acid has a pathogenetic contribution towards accelerated atherogenesis of blood vessels of subjects with hyperuricemia. The objective of this work was to find out the prevalence of hyperuricemia in subjects who presented with unstable angina/myocardial infarction and their prognosis. Methods: This cross-sectional study was carried out in the Cardiology unit of Ayub Teaching Hospital, Abbottabad from 1st September, 2018 to 28th February, 2019. One hundred and ninety-nine subjects who were diagnosed with acute coronary syndrome (ACS) were enrolled in this study using non-probability consecutive sampling. ACS was diagnosed on the basis of history, electrocardiogram (ECG) findings and on the presence of elevated cardiac biomarkers. Uric acid levels were checked in less than 24 hours of presentation and subjects were grouped into hyperuricemic and normouricemic groups according to their serum levels of uric acid. After those patients in both groups were observed by comparing the presence or absence of complications between the two groups. The data was collected on a structured proforma and was statistically assessed with the help of version 16 of SPSS software. Results: Among 199 study participants, there were 146 (73.37%) male and 53 (26.63%) female patients. The mean age of patients in this study was 57.99±6.07 years with a range of 48–68 years. Hyperuricemia was diagnosed in 50 (25.13%) study participants. Among complications, 15 patients (7.94%) had cardiogenic shock, 27 (13.57%) had heart failure, 10 (5.03%) had cardiac arrhythmias, 16 (8.04%) had conduction defects and hyperuricemia was diagnosed in 50 (25.13%) patients. Cardiogenic shock was more common in patients with hyperuricemia (p<0.05). Conclusion: Hyperuricemia can result in multiple complications in patients who have an acute coronary event. Regular screening / monitoring of serum uric acid level in general population can prevent the direct as well as indirect morbidity associated with hyperuricemia.