A Study of the Serum Uric Acid Level as Prognostic Indicator in Acute Myocardial Infarction.

BACKGROUND

Coronary artery disease (CAD) is the leading cause of mortality and morbidity in present days. Recent epidemiological and clinical evidences suggest that serum uric acid can be one of the useful markers in assessing the risk of mortality in acute myocardial infarction.

OBJECTIVE

To find out the association in serum uric acid level and Killip classes and ejection fraction.

METHODOLOGY: It was an observational prospective study. 100 patients of acute myocardial infarction were enrolled and physical examination with special reference to Killip classification, ECG, 2D- Echocardiogram, Serum uric acid and all routine investigations were carried out on 0, 3rd and 7th day. Serum uric acid and Killip class and ejection fractions on day 0, day 3 and day 7 were compared.

RESULTS

In this present study majority of the patients were in the age group of >50 years (68%). There was statistically significant increase in uric acid levels with increasing Killip class on day 0, day 3 and day 7. Mean serum uric acid level was 4.4 mg/dl in Killip class I, 7.01 mg/dl in class II, 8.29 mg/dl in class III, and 9.87 mg/ dl in class IV on day 0; 4.46 mg/dl in Killip class I, 7.09 mg/dl in class II, 8.53 mg/ dl in class III, and 9.43 mg/dl in class IV on day 3; 4.72 mg/dl in Killip class I, 6.62 mg/dl in class II, on day 7. There was statistically significant negative correlation (p-value 0.0009, 0.001, 0.0326 at day 0, 3 & 7) between serum uric acid levels and ejection fraction at all the three occasions i.e. day 0, day 3 and day 7.

CONCLUSION

The present study concludes that serum uric acid level have significant association with Killip class, left ventricular failure and mortality i.e. higher the serum uric acid, higher the Killip class, more severe left ventricular dysfunction and higher the mortality.The present study concludes that serum uric acid level have significant association with Killip class, left ventricular failure and mortality i.e. higher the serum uric acid, higher the Killip class, more severe left ventricular dysfunction and higher the mortality.