Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China
Background: Serum uric acid (UA) has been associated with adverse outcomes in patients with heart failure. However, it remains inconclusive whether such association persists in patients with cardiorenal syndrome (CRS). Methods: In a nationwide prospective cohort from China, 4907 adults hospitalized...
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Elsevier
2025-06-01
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| Series: | International Journal of Cardiology. Cardiovascular Risk and Prevention |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772487525000431 |
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| author | Zhanyuan Chen Yaoyao Wang Lili Liu Xuejiao Liu Rui Zhu Yu Wei Lihua Zhang Jianfang Cai |
| author_facet | Zhanyuan Chen Yaoyao Wang Lili Liu Xuejiao Liu Rui Zhu Yu Wei Lihua Zhang Jianfang Cai |
| author_sort | Zhanyuan Chen |
| collection | DOAJ |
| description | Background: Serum uric acid (UA) has been associated with adverse outcomes in patients with heart failure. However, it remains inconclusive whether such association persists in patients with cardiorenal syndrome (CRS). Methods: In a nationwide prospective cohort from China, 4907 adults hospitalized for heart failure were enrolled. Of them, 1284 had an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 at admission were included in this study. The Cox regression model was employed to evaluate the relationship between UA levels and mortality, major cardiovascular events (MACE), and hospitalization for heart failure (HHF). Additionally, Harrell’s concordance index was utilized to assess the incremental value of UA levels in predicting mortality. Results: During a median follow-up of 3.28 years, hyperuricemia was associated with a 27 % increased risk of all-cause mortality (HR 1.27, 95 % confidence interval [CI] 1.08–1.49) and a 36 % increased risk of cardiovascular mortality (HR 1.36, 95 % CI 1.11–1.65), regardless of patients' eGFR levels. This relationship remained consistent throughout the whole follow-up period. Hyperuricemia increased the risk of 3-month MACE by 39 % (HR 1.39, 95 % CI 1.03–1.88), 3-month HHF by 47 % (HR 1.47, 95 % CI 1.11–1.95), and 1-year MACE by 26 % (HR 1.26, 95 % CI 1.02–1.57). The additive effect of uric acid levels in predicting mortality was also confirmed. Conclusions: Serum UA levels possess significant value in prognosis of mortality, MACE, and HHF among patients with CRS. These findings underscore the importance of monitoring serum UA in the management of patients with CRS, as UA may provide valuable insights into risk stratification. |
| format | Article |
| id | doaj-art-9ebc443042004d888d73bd1c10eca501 |
| institution | DOAJ |
| issn | 2772-4875 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| spelling | doaj-art-9ebc443042004d888d73bd1c10eca5012025-08-20T03:09:44ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-06-012520040510.1016/j.ijcrp.2025.200405Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in ChinaZhanyuan Chen0Yaoyao Wang1Lili Liu2Xuejiao Liu3Rui Zhu4Yu Wei5Lihua Zhang6Jianfang Cai7Department of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaDepartment of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaDepartment of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaDepartment of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaDepartment of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaDepartment of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaNational Clinical Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, ChinaDepartment of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037, Beijing, China; Corresponding author. Department of Nephrology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Rd, Xicheng District, Beijing, 100037, China.Background: Serum uric acid (UA) has been associated with adverse outcomes in patients with heart failure. However, it remains inconclusive whether such association persists in patients with cardiorenal syndrome (CRS). Methods: In a nationwide prospective cohort from China, 4907 adults hospitalized for heart failure were enrolled. Of them, 1284 had an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 at admission were included in this study. The Cox regression model was employed to evaluate the relationship between UA levels and mortality, major cardiovascular events (MACE), and hospitalization for heart failure (HHF). Additionally, Harrell’s concordance index was utilized to assess the incremental value of UA levels in predicting mortality. Results: During a median follow-up of 3.28 years, hyperuricemia was associated with a 27 % increased risk of all-cause mortality (HR 1.27, 95 % confidence interval [CI] 1.08–1.49) and a 36 % increased risk of cardiovascular mortality (HR 1.36, 95 % CI 1.11–1.65), regardless of patients' eGFR levels. This relationship remained consistent throughout the whole follow-up period. Hyperuricemia increased the risk of 3-month MACE by 39 % (HR 1.39, 95 % CI 1.03–1.88), 3-month HHF by 47 % (HR 1.47, 95 % CI 1.11–1.95), and 1-year MACE by 26 % (HR 1.26, 95 % CI 1.02–1.57). The additive effect of uric acid levels in predicting mortality was also confirmed. Conclusions: Serum UA levels possess significant value in prognosis of mortality, MACE, and HHF among patients with CRS. These findings underscore the importance of monitoring serum UA in the management of patients with CRS, as UA may provide valuable insights into risk stratification.http://www.sciencedirect.com/science/article/pii/S2772487525000431Cardiorenal syndromeRenal functionHeart failureUric acidMortality |
| spellingShingle | Zhanyuan Chen Yaoyao Wang Lili Liu Xuejiao Liu Rui Zhu Yu Wei Lihua Zhang Jianfang Cai Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China International Journal of Cardiology. Cardiovascular Risk and Prevention Cardiorenal syndrome Renal function Heart failure Uric acid Mortality |
| title | Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China |
| title_full | Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China |
| title_fullStr | Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China |
| title_full_unstemmed | Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China |
| title_short | Hyperuricemia and adverse outcomes in patients with cardiorenal syndrome: A nationwide prospective cohort study in China |
| title_sort | hyperuricemia and adverse outcomes in patients with cardiorenal syndrome a nationwide prospective cohort study in china |
| topic | Cardiorenal syndrome Renal function Heart failure Uric acid Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2772487525000431 |
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