The Association Study Between Serum Uric Acid Level And Acute Myocardial Infarction And The Severity Of Coronary Stenosis In Patients With Coronary Heart Disease In Yibin Region

Objective: The aim of this study,performed by retrospective analysis,was to investigate the association between serum uric acid and acute myocardial infarction,and the association between serum uric acid and the severity of coronary stenosis in patients with coronary heart disease in Yibin region.Methods: We collected 493 patients(male=350 cases,female=143 cases)from June,2016 to Dec,2017,who had not hospitalized ever,diagnosed as coronary atherosclerotic heart disease by coronary arteriography during hospitalizing in the Department of Cardiology,the second hospital of Yibin(Yibin,China).And we diveded them into two groups,one goup is the AMI(Male=158 cases,female=51cases,mean age 62.26±11.00),another is the control subjects(Male=192 cases,female=92 cases,mean age 60.93±8.20),by checking the results of medical records and myocardial injury markers.Through checking medical records and nursing records list,biochemical data(fasting state)and coronary angiography diagnosis report and image,access to patients' age,gender,height,weight,smoking history,hypertension history,diabetes history,glycosylated hemoglobin,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,serum uric acid,creatinine and so on.Gensini score was applied to evaluate the severity of coronary stenosis in patients with coronary heart disease.Independent sample t-test and chi-squar test were used to compare the clinical data of AMI group and control group.Independent sample t-test and chi-squar test was used to compare the clinical data of male and female patients in AMI group.The correlation between serum uric acid and AMI were analyzed by binary Logistic regression.According to different serum uric acid level,Gensini score of CHD patients were compared by single sample t-test,Gensini score between the AMI group and the control group of different blood uric acid levels independent sample t-test.The correlation between serum uric acid level and Gensini score was analyzed by linear regression.Results: 1.A total of 493 patients with CHD were enrolled.The AMI group(male =158,female =51)was compared with the control group(male =192,female =92),the levels of TC,TG,LDL-C,sUA,Cr,and the prevalence of hypercholesterolemia,hypertriglyceridemia,hyperuricemia were higher than those in control group(P<0.05 for all),but the level of HDL-C was lower than the control group(P<0.05).Indicators such as age,sex,BMI,smoking,HbA1 c,and the prevalence of hypertension,diabetes showed no significant difference between the two groups(P>0.05 for all).The AMI group was divided into male and female groups,compared to the female group(n=51),indicators of the male group(n=158)such as TC,TG,and the prevalence of smoking,diabetes,hypertriglyceridemia,were higher than those in female group(P<0.05 for all),but hyperuricemia lower than female group(P<0.05).Indicators of age,BMI,HDL-C,LDL-C,sUA,Cr,hypertension prevalence,and hypercholesterolemia prevalence were not statistically significant between the two groups(P>0.05 for all).2.Single factor binary Logstic regression analysis showed that the indicators such as hypercholesterolemia,hypertriglyceridemia,hyperuricemia,HDL-C,and Cr were correlated with AMI(P<0.05 for all).Multivariate Logstic regression analysis showed that hyperuricemia was still independent with AMI(OR=5.03,95%CI:3.158—8.01,P<0.001)after adjusting for other indicators.Stratified analysis based on gender,single factor binary Logstic regression analysis found that hypercholesterolemia,hypertriglyceridemia,hyperuricemia,HDL-C,and Cr were correlated with AMI in male patients(P<0.05 for all).Hypertension,diabetes,hyperuricemia and HDL-C were correlated with AMI in female patients.Furthermore,multivariate Logstic regression analysis showed that hyperuricemia is still associated with AMI after adjusting for other influencing factors,not only in male patients(OR=6.444,95%CI:3.427—12.117,P<0.001),also in female patients(OR=9.494,95%CI:3.452—26.109,P<0.001).3.CHD patients were divided into three groups,according to serum uric acid level.We found the higher the serum uric acid level in CHD patients,the higher the lg(Gensini score)(P<0.05);And the different serum uric acid concentration,AMI group lg(Gensini score)was higher than the control group(P < 0.05).So,we can speculate that the higher the serum uric acid concentration,the higher the Gensini score.And at different levels of uric acid,the Gensini score in the AMI group was higher than that in the control group.4.In CHD patients,the results of single factor linear regression analysis showed that there was a linear regression relationship between Age,HbA1 c,TC,HDL-C,LDL-C,sUA,Cr and lg(Gensini score)in male patients(P<0.05 for all);there was a linear regression relationship between BMI,HDL-C,sUA and lg(Gensini score)(P<0.05 for all).The results of multivariate linear regression analysis showed that,in male CHD patients,sUA and lg(Gensini score)still had independent correlation after adjusting for other indicators(Beta=0.132,95%CI:0.000—0.001,P=0.014),as well as in women CHD patients(Beta=0.291,95%CI:0.001—0.002,P=0.001).Conclusion: We found that hyperuricemia independently associated with the incidence of acute myocardial infarction in patients with coronary heart disease in Yibin region.In addition,the higher the serum uric acid level in patients with coronary heart disease,the higher the Gensini score.And the level of serium uric acid independently associated with the severity of coronary stenosis in patients with coronary heart disease.