The relationship between serum uric acid levels within 24 h of admission and all-cause mortality within 1 year after discharge in patients with acute heart failure

Guo Ruirui; He Zhuoqiao; Zhou Yan; Tian Cuihong; Zhang Kui; Guo Wenyu; Gao Jiajia; Peng Lirong; Xu Yan; Tan Xuerui

doi:10.3760/j.issn.1673-4777.2024.02.004

Abstract：Objective To explore the relationship between serum uric acid levels within 24 h of admission and all-cause mortality within 1 year after discharge in patients with acute heart failure(AHF).Methods Totally 598 AHF patients who were hospitalized in the heart failure ward of Fuwai Hospital Chinese Academy of Medical Sciences,Shenzhen from June 2018 to June 2021 were selected.According to the median of serum uric acid(496 μmol/L)within 24 h of admission,patients were divided into high serum uric acid group(297 cases,49.7％,＞496 μmol/L)and low serum uric acid group(301 cases,50.3％,≤496 µmol/L).Each subject was followed up by outpatient examination or telephone for 1 year.The end point of follow-up was all-cause mortality.The Kaplan-Meier curve was used to evaluate the cumulative incidence of all-cause mortality.Cox proportional hazards regression model was used to analyze the effect of elevated serum uric acid level on all-cause mortality within 1 year after discharge from hospital.Results Compared with the low serum uric acid group,the high serum uric acid group had a higher proportion of males,younger age,higher body mass index,worse heart function,higher serum creatinine and N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)levels,and higher proportion of patients receiving β-receptor blockers,loop diuretics,and intravenous diuretics(all P＜0.05).All-cause death occurred in 87(14.5％)of 598 AHF patients within 1 year of follow-up,including 54(18.2％)in the high serum uric acid group and 33(11.0％)in the low serum uric acid group.The Kaplan-Meier curve showed that during the one-year follow-up period,the cumulative incidence of all-cause death in the high serum uric acid group was significantly higher than that in the low serum uric acid group(Log-rank P=0.012).After adjusting for age,gender,body mass index,New York Heart Association functional class,left ventricular ejection fraction,NT-proBNP,serum creatinine,use of β-receptor blockers and diuretics,the risk of all-cause mortality in the high serum uric acid group was 1.735 times higher than that in the low serum uric acid group(P=0.020).Conclusion Elevated serum uric acid level within 24 h of admission is an independent risk factor for increased risk of all-cause death in AHF patients within 1 year after discharge.