Background: It is still debated whether serum uric acid (SUA) is an independent risk factor for coronary artery disease (CAD) or not. We tried to investigate the association of SUA with CAD.
Methods: We sought to evaluate a total of 437 patients underwent coronary angiogram, clinical, and laboratory investigations in cross-sectional study. The patients were divided into 2 groups according to presence or absence of CAD (defined by ≥50% stenosis in major coronary vessels).
Results: SUA was 5.4 ± 1.6 mg/dL (5.0 ± 1.6 in female and 5.7 ± 1.6 in male, P<0.0001). Sex-specific hyperuricemia (SUA >6 mg/dL in female and >7 mg/dL in male) was present in 18.8% of the patients. The prevalence of CAD was 51.0%. Areas on the ROC curves of SUA for CAD prediction were 0.604 in female, 0.479 in male and 0.561 in all.
Hyperuricemia was not associated with CAD (+/-) (P=0.078), and SUA groups categorized by quartiles also were not associated with CAD (+/-) (P for trend=0.092) in univariate analysis. Only, SUA in CAD was significantly high (5.5 ± 1.7 in CAD versus 5.2 ± 1.7 mg/dL in no CAD, P=0.019). Hyperuricemia was independently assoiciated with CAD (+/-) in linear logistic regression including sex, age quartiles groups, body mass index (BMI) (<25, 25-29.9, and >30 kg/m2), diabetes mellitus (DM), hypertension (HT), chronic kidney disease (CKD), hyperlipidemia, Hs-CRP (<0.1, 0.1-0.3, and >0.3 mg/dL), smoking habitus (never, ex-, and current), alcohol consumption (never, social, and heavy), and thiazide use (P=0.006).
Hyperuricemia and SUA were associated with CAD severity (numbers of coronary artery in ≥50% stenosis) (P for trend=0.044 and P for trend=0.030, respectively). Another CAD severity (modified Genini’s score) was associated with hyperuricemia (P=0.006), and not SUA (P=0.097). And the associations of hyperuricemia and SUA with CAD severity (numbers of coronary artery in ≥50% stenosis) were lost after adjustment for sex, age, BMI, DM, HT, eGFR (estimated glomerular filteration rate by MDRD formula), total cholesterol (mg/dL), Hs-CRP, smoking habitus, alcohol consumption, and thiazide use (P=0.126 and P=0.447, respectively). Also the associations of hyperuricemia and SUA with another CAD severity (modified Genini’s score) were absent after adjustment for above all variables (P=0.358 and P=0.521, respectively).
Conclusions: Female is more related with association between SUA and CAD. Hyperuricemia is independently associated with the presence or absence of CAD. Hyperuricemia and SUA are associated with CAD severity, not an independent association. Consequently, hyperuricemia is an independent risk factor for the presence of CAD, not CAD severity.
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