JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
The assessment of serum uric acid-to-HDL cholesterol ratio as a new predictor of mortality in ST-elevation myocardial infarction: a cross-sectional study
Abstract
Aims: The objective of this study was to evaluate the predictive efficacy of the Uric Acid-to-High Density Lipoprotein Cholesterol Ratio (UHR) as a novel inflammatory and metabolic marker for mortality in patients with ST-segment Elevation Myocardial Infarction (STEMI).
Methods: This retrospective, single-center, cross-sectional, observational study enrolled 1361 patients diagnosed with STEMI undergoing primary percutaneous coronary intervention (PPCI) from March 2021, to January 2022. The participants were categorized into two groups: those experiencing in-hospital mortality (n=100) and those without in-hospital mortality (n=1265).
Results: In-hospital mortality occurred in 100 patients (7.3%). UHR was notably higher in the mortality group compared to the non-mortality group (23.6±14.9% vs. 15.3±6.9%, p<0.001). Logistic regression analysis identified several independent determinants of in-hospital mortality among STEMI patients, including age (odds ratio [OR]=1.050, p<0.001), the presence of DM (OR=2.077, p=0.016), serum glucose (OR=1.004, p=0.002), hemoglobin (OR=0.855, p=0.020), White blood cell count (OR=1.064, p=0.025), UHR (OR=1.683, p<0.001), and SYNTAX score (OR=1.099, p<0.001). Receiver operating characteristic curve analysis revealed that UHR>13.9% determined in-hospital mortality in STEMI patients who underwent PPCI with 81.1% sensitivity and 49.2% specificity (AUC=0.668, p=0.001)
Conclusion: The UHR exhibited a significant and independent positive correlation with in-hospital mortality among STEMI patients undergoing PPCI.

Keywords : Uric acid, HDL-C, uric acid-to-high density lipoprotein cholesterol ratio, STEMI, SYNTAX score, in-hospital mortality

Download Article


1. Mathers CD, Boerma T, Ma Fat D. Global and regional causes ofdeath. Br Med Bull. 2009;92(1):7-32.
2. Anderson JL, Morrow DA. Acute myocardial infarction. NEJM.2017;376(21):2053-2064.
3. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for themanagement of acute myocardial infarction in patients presentingwith ST-segment elevation: The Task Force for the managementof acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).Eur Heart J. 2018;39(2):119-177.
4. Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for themanagement of acute coronary syndromes in patients presentingwithout persistent ST-segment elevation: The Task Force for themanagement of acute coronary syndromes in patients presentingwithout persistent ST-segment elevation of the European Societyof Cardiology (ESC). Eur Heart J. 2021;42(14):1289-1367.
5. Zeymer U, Ludman P, Danchin N, et al. Reperfusion therapies andin-hospital outcomes for ST-elevation myocardial infarction inEurope: the ACVC-EAPCI EORP STEMI Registry of the EuropeanSociety of Cardiology. Eur Heart J. 2021;42(44):4536-4549.
6. Chuang SY, Chen JH, Yeh WT, Wu CC, Pan WH. Hyperuricemiaand increased risk of ischemic heart disease in a large Chinesecohort. Int J Cardiol. 2012;154(3):316-321.
7. Li L, Zhao M, Wang C, et al. Early onset of hyperuricemia isassociated with increased cardiovascular disease and mortalityrisk. Clin Res Cardiol. 2021;110(7):1096-1105.
8. Goldbourt U, Yaari S, Medalie JH. Isolated low HDL cholesterolas a risk factor for coronary heart disease mortality: a 21-yearfollow-up of 8000 men. Arterioscler Thromb. 1997;17(1):107-113.
9. Yu S, Guo X, Li GX, Yang H, Zheng L, Sun Y. Lower or higherHDL-C levels are associated with cardiovascular events in thegeneral population in rural China. Lipids Health Dis. 2020;19(1):1-6.
10. Kosekli MA, Kurtkulagii O, Kahveci G, et al. The associationbetween serum uric acid to high density lipoprotein-cholesterolratio and non-alcoholic fatty liver disease: the abund study. RevAssoc Med Bras. 2021;67:549-554.
11. Zhou Y, Wei F, Fan Y. High serum uric acid and risk ofnonalcoholic fatty liver disease: a systematic review and meta-analysis. Clin Biochem. 2016;49(7-8):636-642.
12. Kocak MZ, Aktas G, Erkus E, Sincer I, Atak B, Duman T. Serumuric acid to HDL-cholesterol ratio is a strong predictor ofmetabolic syndrome in type 2 diabetes mellitus. Rev Assoc MedBras. 2019;65(1):9-15.
13. Zhang YN, Wang QQ, Chen YS, Shen C, Xu CF. Associationbetween serum uric acid to hdl-cholesterol ratio and nonalcoholicfatty liver disease in lean chinese adults. Int J Endocrinol.2020;2020:5953461.
14. Kurtkulagi O, Tel BMA, Kahveci G, et al. Hashimoto&rsquo;s thyroiditisis associated with elevated serum uric acid to high densitylipoprotein-cholesterol ratio. Rom J Intern Med. 2021;59(4):403-408.
15. Aktas G, Kocak MZ, Bilgin S, Atak BM, Duman TT, KurtkulagiO. Uric acid to HDL cholesterol ratio is a strong predictor ofdiabetic control in men with type 2 diabetes mellitus. Aging Male.2020;23(5):1098-1102.
16. Sianos G, Morel MA, Kappetein AP, et al. The SYNTAX Score:an angiographic tool grading the complexity of coronary arterydisease. EuroIntervention. 2005;1(2):219-227.
17. Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospitalmortality in the global registry of acute coronary events. ArchIntern Med. 2003;163(19):2345-2353.
18. Stolt Steiger V, Goy JJ, Stauffer JC, et al. Significant decrease inin-hospital mortality and major adverse cardiac events in SwissSTEMI patients between 2000 and December 2007. Swiss MedWkly. 2009;139(31-32):453-457.
19. Cretu DE, Udroiu CA, Stoicescu CI, Tatu-Chitoiu G, VinereanuD. Predictors of in-hospital mortality of ST-segment elevationmyocardial infarction patients undergoing interventionaltreatment. An analysis of data from the RO-STEMI registry.Maedica. 2015;10(4):295-303.
20. Gale CP, Manda S, Batin PD, Weston CF, Birkhead JS, Hall AS.Predictors of in-hospital mortality for patients admitted withST-elevation myocardial infarction: a real-world study using theMyocardial Infarction National Audit Project (MINAP) database.Heart. 2008;94(11):1407-1412.
21. Alves L, Ziegelmann PK, Ribeiro V, Polanczyk C. Hospitalmortality from myocardial infarction in Latin America andthe Caribbean: systematic review and meta-analysis. Arq BrasCardiol. 2022;119(6):970-978.
22. Xu Y, Zhu J, Gao L, et al. Hyperuricemia as an independentpredictor of vascular complications and mortality in type 2diabetes patients: a meta-analysis. PloS One. 2013;8(10):e78206.
23. Mortada I. Hyperuricemia, type 2 diabetes mellitus, andhypertension: an emerging association. Curr Hypertens Rep. 2017;19(9):69.
24. Cheng KH, Chu CS, Lin TH, Lee KT, Sheu SH, Lai WT. Lipidparadox in acute myocardial infarction&mdash;the association with 30-day in-hospital mortality. Crit Care Med. 2015;43(6):1255-1264.
25. Reddy VS, Bui QT, Jacobs JR, Begelman SM, Miller DP, FrenchWJ. Relationship between serum low-density lipoproteincholesterol and in-hospital mortality following acute myocardialinfarction (the lipid paradox). Am J Cardiol. 2015;115(5):557-562.
26. Ji MS, Jeong MH, Ahn YK, et al. Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fastingstate on the clinical outcomes in patients with acute myocardialinfarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction). J Cardiol. 2015;65(1):63-70.
27. Yang Y, Zhang J, Jia L, Su J, Ma M, Lin X. The interactionbetween uric acid and high-density lipoprotein cholesterol onthe prognosis of patients with acute myocardial infarction. FrontCardiovasc Med. 2023;10:1226108.
28. Hu X, Liu J, Li W, et al. Elevated serum uric acid was associatedwith pre-inflammatory state and impacted the role of HDL-Con carotid atherosclerosis. Nutr Metab Cardiovasc Dis.2022;32(7):1661-1669.
29. Mansiroglu AK, Cekici Y, Sincer I, Gunes Y. Serum uric acid anduric acid to HDL-cholesterol ratio in coronary artery fistulas.Ann Med Res. 2019;26(12):2771-2775.
30. Aydın C, Emlek N. The relationship between uric acid to high-density lipoprotein cholesterol ratio and collateral index inpatients with chronic total occlusion. Kardiologiia. 2021;61(9):61-65.
31. Li F, Zhao D, Li Q, Lin X, Sun H, Fan Q. Uric acid to high-density lipoprotein cholesterol ratio is a novel marker to predictfunctionally significant coronary artery stenosis. J Interv Cardiol.2022;2022:9057832.
32. Rencuzogullari I, &Ccedil;ağdaş M, Karakoyun S, et al. Associationof Syntax Score II with contrast-induced nephropathy andhemodialysis requirement in patients with ST segment elevationmyocardial infarction undergoing primary percutaneouscoronary intervention. Korean Circ J. 2018;48(1):59-70.
33. Alıcı G, Barman HA, Atıcı A, Tuğrul S, Gen&ccedil; &Ouml;, Şahin İ. Theimpact of lesion complexity and the CHA 2 DS 2-VASc score onspontaneous reperfusion in patients with ST-segment elevationmyocardial infarction. Int J Clin Pract. 2022;2022:8066780.
34. Cirakoglu OF, Aslan AO, Akyuz AR, et al. The value of syntaxscore to predict new-onset atrial fibrillation in patients withacute coronary syndrome. Ann Noninvasive Electrocardiol.2019;24(4):e12622.
35. Kul S, Akgul O, Uyarel H, et al. High SYNTAX score predictsworse in-hospital clinical outcomes in patients undergoingprimary angioplasty for acute myocardial infarction. CoronArtery Dis. 2012;23(8):542-548.
36. Alıcı G, Gen&ccedil; &Ouml;, Urgun &Ouml;D, et al. The value of PRECISE-DAPTscore and lesion complexity for predicting all-cause mortality inpatients with NSTEMI. Egypt Heart J. 2023;75(1):1-7.
37. Ali M, Lange S, Wittlinger T, Lehnert G, Rigopoulos A,Noutsias M. In-hospital mortality after acute STEMI in patientsundergoing primary PCI. Herz. 2018;43(8):741-745.
38. Sanguanwong S, Srimahachota S, Tungsubutra W, SrichaivethB, Kiatchoosakun S. Predictors of in-hospital mortality inThai STEMI patients: results from TACSR. J Med Assoc Thai.2007;90(Suppl 1):91-97.
39. Almeida I, Miranda H, Santos H, et al. Prognostic value ofBNP in STEMI patients. Eur Heart J Acute Cardiovasc Care.2021;10(Supplement_1):zuab020-093.
40. Akgul O, Uyarel H, Pusuroglu H, et al. High BNP level as riskfactor for acute kidney injury and predictor of all-cause mortalityin STEMI patients. Herz. 2014;39(4):507-514.
41. Caputo RP, Goel A, Pencina M, et al. Impact of drug eluting stentlength on outcomes of percutaneous coronary intervention (fromthe EVENT registry). Am J Cardiol. 2012;110(3):350-355.
42. Konishi H, Miyauchi K, Dohi T, et al. Impact of stent length onclinical outcomes of first-generation and new-generation drug-eluting stents. Cardiovasc Interv Ther. 2016;31(2):114-121.
43. Moghaddam N, Wong GC, Cairns JA, et al. Association ofanemia with outcomes among ST-segment-elevation myocardialinfarction patients receiving primary percutaneous coronaryintervention. Circ Cardiovasc Interv. 2018;11(12):e007175.
44. Rousan TA, Pappy RM, Chen AY, Roe MT, Saucedo JF. Impactof diabetes mellitus on clinical characteristics, management, andin-hospital outcomes in patients with acute myocardial infarction(from the NCDR). Am J Cardiol. 2014;114(8):1136-1144.
Article available in :
Volume 5, Issue 1, 2024
Page : 57-64
https://doi.org/10.47582/jompac.1405773
Article Information
Submitted : 16 Ara 2023
Accepted : 19 Şub 2024
Corresponding Author :

Ömer Genç: Department of Cardiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkiye

[email protected]
Citation : Genç Ö, Yıldırım A, Özkan E. The assessment of serum uric acid-to-HDL cholesterol ratio as a new predictor of mortality in ST-elevation myocardial infarction: a cross-sectional study. J Med Palliat Care. 2024;5(1):57-64.

Read: 54
Cited: 0
Download : 15
_Footer