Elevated postoperative serum uric acid is associated with major adverse events following coronary artery bypass grafting. Issue 10 (28th September 2020)

• Record Type: Journal Article
• Authors: Shi, Ye; Zhang, Xiaoqian; Du, Juan; Chen, Sipeng; Zhang, Heng; Yang, Limeng; Zheng, Zhe
• Is Part Of: Journal of cardiac surgery. Volume 35:Issue 10(2020)
• Page Start: 2559
• Page End: 2566
• Publication Date: 2020-09-28
• Subjects: coronary artery bypass grafting -- major adverse cardiac and cerebrovascular events -- mortality -- postoperative uric acid; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.14845
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Background: Few data are available on the association between postoperative serum uric acid (SUA) level and poor survival in patients undergoing coronary artery bypass grafting (CABG). We evaluated the relationship between postoperative SUA and major adverse cardiac and cerebrovascular events (MACCE) among patients undergoing CABG. Methods: This study used data from 1614 consecutive patients undergoing CAGB at Fuwai Hospital (Beijing, China) from 2011 to 2015. Patients were stratified into statistical quartiles of postoperative SUA (between 6 and 18 hours after cardiac surgery): less than 203.7, 203.7 to 254.1, 254.1 to 316.6, and ≥316.6 µmol/L. The association of postoperative SUA with MACCE (ie, death, myocardial infarction [MI], stroke, or repeat revascularization) and the composite endpoint of mortality/MI were assessed. Results: Patients had a mean age of 60.3 ± 8.4 years, and 79.3% were male. During mean follow‐up of 2.5 ± 0.7 years, MACCE occurred in 201 (12.5%) patients. In separate multivariable regression models, postoperative SUA level was positively associated with in‐hospital MACCE (highest vs lowest SUA quartile: odds ratio [OR]: 2.40; 95% confidence interval [CI]: 1.29, 4.48; P = .006) and in‐hospital composite endpoint of mortality/MI (OR: 2.88; 95% CI: 1.45, 5.72; P = .003), respectively. And elevated postoperative SUA level was independently associated with MACCE (Hazard ratio [HR]: 1.70; 95% CI: 1.12, 2.57; P = .01) and the composite endpoint of mortality/MI (HR: 2.42; 95% CI: 1.32, 4.43; P = .004) respectively within 3 years after CABG. Conclusions: Elevated postoperative SUA level is associated with poor clinical outcomes after CABG. Patients with high postoperative SUA levels after CABG might require to be closely monitored.