Effect Of Serum Uric Acid Level On Long-Term Prognosis Of STEMI Patients After Emergency PCI

Objective: To investigate the effect of serum uric acid(SUA)level on the long-term prognosis of patients with ST-segment elevation myocardial infarction(SETMI)who underwent emergency percutaneous coronary intervention(PCI).Methods: 275 patients who were diagnosed as STEMI and successfully performed emergency PCI in Cardiovascular Medicine Department of The First Affiliated Hospital of Henan University of Science and Technology from January 1,2012 to December 31,2012 were enrolled in this study.They were divided into low uric acid group(91 cases),moderate uric acid group(90 cases)and high uric acid group(94 cases)according to the three-point method of blood uric acid level at admission.The clinical baseline data including smoking history,past medical history,hematological indicators such as white blood cells,hemoglobin,total cholesterol,triglycerides,plasma atherogenic index of plasma(AIP)and coronary angiography results were collected and analyzed.Major adverse cardiovascular events(MACE)were observed during hospitalization and 6-year follow-up after emergency PCI in the three groups.The effects of different levels of serum uric acid on short-term and long-term prognosis of patients were analyzed.Results: The clinical baseline data of the three groups showed that there were significant differences in male,blood urea nitrogen,serum creatinine between the three groups(all P < 0.05),There was no significant difference in other indicators(P >0.05).Coronary angiography showed that the proportion of three vessel lesions in the hyperuric acid group was higher than that in the other two groups(P = 0.025).The total incidence of MACE during hospitalization was 23.8%,42.2% and 47.9% respectively.The difference was statistically significant(P=0.001).There were significant differences in the incidence of heart failure(P<0.001),stent thrombosis(P=0.032)during hospitalization.There was no significant difference in angina pectoris,cerebrovascular events and in-hospital mortality among the three groups during hospitalization.During the 6-year follow-up period,the incidence of MACE was 29.3%,35.0% and 48.5% respectively,The difference was statistically significant(P=0.010).There were significant differences in heart failure(P=0.005),angina pectoris(P=0.029)and in-stent restenosis/occlusion(P=0.015)during follow-up.Logistic regression analysis during hospitalization showed that SUA,age and smoking history were riskfactors for MACE in STEMI patients after emergency PCI.Logistic regression analysis during 6 years follow-up showed that SUA(β=0.004,P=0.031),AIP(β=2.535,P=0.005),APTT(β=0.023,P=0.031)were risk factors for long-term prognosis.Conclusion: SUA level is an independent risk factor for short-term and long-term prognosis in STEMI patients who successfully perfoemed emergency PCI.Elevated SUA level increases the incidence of long-term MACE.