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Prevalence and prognostic association of hyperuricemia in heart failure patients with reduced ejection fraction

Session Poster Session 1

Speaker Daniel Seabra

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : I Pereira Oliveira (Penafiel,PT), D Seabra (Penafiel,PT), A Leal Neto (Penafiel,PT), A Andrade (Penafiel,PT), J Azevedo (Penafiel,PT), P Pinto (Penafiel,PT)

Authors:
I Pereira Oliveira1 , D Seabra1 , A Leal Neto1 , A Andrade1 , J Azevedo1 , P Pinto1 , 1Hospital Centre do Tamega e Sousa - Penafiel - Portugal ,

Citation:

Introduction: Substantial evidence advocates that uric acid (UA) is an independent marker for adverse prognosis in chronic HF of varying severity. Serum UA, produced in the terminal step of purine nucleotide metabolism by xanthine oxidase (XO), seems to be a predictor of mortality in HFrEF, independent of chronic kidney disease (CKD). Whether UA is simply a marker of dismal prognosis or an active contributor in disease pathogenesis is currently unknown.

Purpose: To appraise the association of UA levels with clinical features and prognosis in pts with HF and reduced ejection fraction (HFrEF) in a Heart Failure Clinic (HFC).

Methods: Unicentric, retrospective analysis of pts followed in a HFC since 3/2011. Included pts with reduced ejection fraction (EF) (<50%) and previous diagnosis for at least 6 months. The pts were divided into 2 groups: hyperuricemic (G1) and with normal UA levels (G2). Hyperuricemia was defined has serum UA =7.0mg/dL. Clinical, demographic, analytical, electrical, echocardiographic characteristics and major cardiac events – HF hospitalization (HFhosp) and mortality (from cardiovascular cause (CVm) and non-cardiovascular cause (nCVm)) were analysed.

Results: Included 318 pts, mean age 60.4 ± 13.3 years and a mean body mass index (mBMI) of 27.9kg/m2. 74% were male. 41.5% had ischemic etiology. G1 consisting of 153 pts (48%) with mean age of 61.3±13.3 years. There were no differences in age, mBMI and cardiopathy etiology between groups.There were no significant differences in cardiovascular risk factors prevalence, except for smoking (43 vs 32%, p=0.032). The hyperuricemic group correlated positively with the presence of atrial fibrillation (AF) (42 vs 28%, p=0.009) and CKD (41 vs 22%, p<0.001). G1 had more right ventricular dysfunction and lower left ventricular EF (LVEF) at admission (p<0.001). LVEF remained significantly lower in G1 during follow-up (FU) (p=0.045). Although there were no significant differences regarding mortality, G1 pts had more HFhosp (20 vs 12%, p=0.046).

Conclusion: Hyperuricemia was particularly prevalent in this cohort. There were no associations with standard cardiovascular risk factors although hyperuricemic pts had more AF and CKD. Furthermore, higher levels of ventricular dysfunction were observed in this subgroup, with greater presence of biventricular dysfunction and HFhosp.

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