Correlation Between Serum Uric Acid Level And Prognosis Of Patients With Chronic Heart Failure After Revascularization

ObjectiveTo investigate the relationship between serum uric acid?SUA?level and the prognosis of patients with chronic heart failure?CHF?after revascularization,and to explore whether it can be a new method to evaluate the condition of CHF patients and improve cardiac function inclinical treatment,so as to provide basis for the treatment of elderly CHF patients with hyperuricemia?HUA?.Methods150 CHF patients who completed Percutaneous coronary intervention?PCI?or coronary artery bypass graft?CABG?during their hospitalization in the department of cardiology of Jining First People's Hospital from August 2016 to August 2017 were selected,and were divided into two groups according to SUA level:HUA group?96 cases?and uric acid normal group?54 cases?.After revascularization,the HUA group was divided into 2groups at random:the experimental group and the control group,each group had 48 cases.All the patients were treated according to the 2016 European Heart Association Guidelines for the diagnosis and treatment of chronic heart failure in adults,including digoxin,diuretics,angiotensin-converting enzyme inhibitor/angiotensin receptor blocker,?-blocker,and Aldosterone antagonists.During the treatment,all patients were given a low-purine diet to avoid affecting SUA level.The experimental group was treated with allopurinol for 6months.General information of all subjects?including:Age,sex,medical history,heart function grading,medications,etc.?,were recorded before and after treatment as well as the monthly blood sugar,blood fat,serum creatinine?Scr?,blood urea nitrogen?BUN?,uric acid?SUA?,brain natriuretic peptide precursor levels?NT-proBNP?,tumor necrosis factor?TNF-a?,the levels of interleukin 6?IL-6?.Using echocardiography to determine relevant indicators and calculate the Left ventricular ejection fraction?LVEF?.According to the results of coronary angiography,the coronary lesions and postoperative medication were recorded.The 6min walk test?6MWT?was improved before and after treatment and follow-up.After 6 months of follow-up,measurement indexes were collected and compared with the control group,and endpoint events were recorded as well.Results?1?There was no significant difference in age,gender,body mass index?BMI?,prevalence rate of major associated diseases,location and severity of coronary artery disease between the hyperuricemia group and the normal uric acid group.However,the indicators such as SCr,SUA and NT-proBNP in the hyperuricemia group were significantly higher than those in the normal uric acid group?P<0.01?.?2?Multivariate logistic regression was used to evaluate the occurrence of end-point events in CHF patients.The results showed that hyperuricemia alone was an independent predictor of poor prognosis,OR=2.19,95%CI?1.54-4.02?,P<0.01.?3?According to Pearson correlation test,SUA level was positively correlated with NT-proBNP,SCr,TNF-?and IL-6?r₁=0.982,r₂=0.771,r₃=0.940,r₄=0.799 P<0.01?.SUA level was negatively correlated with LVEF?r=-0.972,P<0.01?.?4?After 6 months of uric acid lowering treatment,the incidence of endpoint events in CHF patients was significantly lower than that in the control group?P<0.05?.?5?After 6 months of follow-up,the incidence of endpoint events in the hyperuricemia group was significantly higher than that in the normal uric acid group.Kaplan-meier curve showed that:as the patient's serum uric acid level increased,the incidence of composite endpoint events in CHF patients after revascularization increased,and the survival rate decreased?P<0.01?.ConclusionSUA level is positively correlated with the mortality and readmission rate of CHF patients after revascularization,and reducing SUA can improve the prognosis of patients with heart failure.