Prognostic role of the serum uric acid-to-serum creatinine ratio in patients with st-elevation myocardial infarction and multivessel coronary artery disease.

BACKGROUND

The aim of this study was to investigate whether serum uric acid to serum creatinine ratio (SUA/SCr) predicts the early major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with ST elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVCAD).

METHODS

This study was designed retrospectively and included 572 patients with a mean age of 61.9 ± 12.3 years who presented with STEMI and had MVCAD. The patients were divided into 2 groups as those with and without MACCEs, taking into account the 30-day follow-up period. Serum uric acid, and serum creatinine were obtained at admission. The SUA/SCr of all patients were calculated and evaluated the relationship of SUA/SCr with the 30-day MACCEs.

RESULTS

During the mean 27.0 ± 7.7 day follow-up period, 58 (10.1%) patients died, and 84 patients (14.7%) suffered MACCEs. According to multivariable cox regression analysis, advanced age (HR: 1.020, p = 0.028), smoking (HR: 2.513, p = 0.001), lower left ventricular ejection fraction (HR: 0.962, p = 0.001), TIMI < 3 flow (HR: 0.425, p < 0.001), higher syntax score (HR: 1.067, p < 0.001), and higher SUA/SCr (HR: 1.1029, p = 0.011) independently predicted the 30-day MACCEs. The area under the curve for SUA/SCr was 0.606 with a p value of 0.002. The Kaplan Meier curves represented that high-risk patients with SUA/SCr greater than 4.58 had significantly higher MACCEs than low-risk group during the follow up period after index hospitalization (p = 0.001).

CONCLUSIONS

Newly defined promising oxidative and inflammatory biomarker, SUA/SCr can be a potential predictor of MACCEs within 30 days and decision-making treatment in STEMI and MVCAD patients.