Prognostic impact of uric acid in patients with acute decompensated heart failure

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Abstract

Aim. To evaluate the prognostic impact of serum uric acid (SUA) on clinical outcomes in patients with acute decompensated heart failure, as well as identify the correlation between hyperuricemia and renal function and diuretic resistance in these patients.

Materials and methods. The study included 175 patients (125 men and 50 women) with NYHA class II–IV acute decompensated heart failure. Median age was 64 (56–75) years. The Information regarding the survival was obtained 3 years after the admission by telephone calls.

Results. 57 patients reached the end point (death from all causes); therefore, all patients were divided into groups: "alive", "dead". The SUA levels did not differ in the groups. The only significant difference in the studied parameters was the estimated glomerular filtration rate (eGFR), which was significantly higher in the "alive" group [70.5 (52.8–94) and 56 (40–79), respectively; p=0.006]. A moderate negative correlation was found between SUA levels and eGFR in the correlation analysis (r=-0.313, p<0.001). A comparative analysis showed, that SUA level on admission was significantly higher in patients who subsequently received increased doses of diuretics than in patients with a satisfactory response to standard doses of diuretics [567.8 (479.6–791.9) and 512 (422.4–619.4), respectively; p=0.011]. Also, higher eGFR level on admission was observed in patients from the normal SUA level group than in patients from the hyperuricemia group [94 (74.5–101.5) and 63 (48.8–81.3), respectively; p=0.002].

Conclusion. We found no significant differences in the uric acid level in patients who reached the end point and those who did not reach it during the three-year follow-up. However, the found correlation between uric acid levels and diuretic resistance calls for further research.

About the authors

Svetlana N. Nasonova

National Medical Research Center of Cardiology

Email: anastasiyalapteva95@gmail.com
ORCID iD: 0000-0002-0920-7417

канд. мед. наук, ст. науч. сотр. отд. заболеваний миокарда и сердечной недостаточности ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

Anastasiya E. Lapteva

National Medical Research Center of Cardiology

Email: anastasiyalapteva95@gmail.com
ORCID iD: 0000-0002-9260-9520

клин. ординатор отд. заболеваний миокарда и сердечной недостаточности ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

Igor V. Zhirov

National Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education

Email: anastasiyalapteva95@gmail.com
ORCID iD: 0000-0002-4066-2661

д-р мед. наук, вед. науч. сотр. отд. заболеваний миокарда и сердечной недостаточности ФГБУ «НМИЦ кардиологии», проф. каф. кардиологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

Dzambolat R. Mindzaev

National Medical Research Center of Cardiology

Author for correspondence.
Email: anastasiyalapteva95@gmail.com
ORCID iD: 0000-0002-2236-3959

аспирант отд. заболеваний миокарда и сердечной недостаточности ФГБУ «НМИЦ кардиологии»

Russian Federation, Moscow

Sergey N. Tereshchenko

National Medical Research Center of Cardiology; Russian Medical Academy of Continuous Professional Education

Email: anastasiyalapteva95@gmail.com
ORCID iD: 0000-0001-9234-6129

д-р мед. наук, проф., рук. отд. заболеваний миокарда и сердечной недостаточности ФГБУ «НМИЦ кардиологии», зав. каф. кардиологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow; Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. Blood uric acid (UA) levels in the "dead" and "live" groups.

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3. Fig. 2. Glomerular filtration rate (GFR) in the "dead" and "alive" groups.

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4. Fig. 3. Correlation between UA levels and GFR.

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5. Fig. 4. GFR in patients with and without hyperuricemia.

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6. Fig. 5. Correlation between UA levels and left ventricular ejection fraction.

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7. Fig. 6. Blood UA levels in patients with "satisfactory response" and "resistant" to standard doses of intravenous diuretics.

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