The role of
uric acid as an independent marker of cardiovascular risk is unclear. Therefore, our aim was to assess the independent contribution of preoperative serum
uric acid levels to the risk of 30-day and late mortality and major
adverse cardiac event (
MACE) in patients scheduled for open
vascular surgery. In total, 936 patients (76% male, age 68 +/- 11 years) were enrolled.
Hyperuricemia was defined as serum
uric acid >0.42 mmol/l for men and >0.36 mmol/l for women, as defined by large epidemiological studies. Outcome measures were 30-day and late mortality and
MACE (
cardiac death or
myocardial infarction). Multivariable logistic and Cox regression analysis were used, adjusting for age, gender, and all cardiac risk factors. Data are presented as odds ratios or hazard ratios, with 95% confidence intervals.
Hyperuricemia was present in 299 patients (32%). The presence of
hyperuricemia was associated with
heart failure,
chronic kidney disease, and the use of
diuretics. Perioperatively, 46 patients (5%) died and 61 patients (7%) experienced a
MACE. Mean follow-up was 3.7 years (range: 0 to 17 years). During follow-up, 282 patients (30%) died and 170 patients (18%) experienced a
MACE. After adjustment for all clinical risk factors, the presence of
hyperuricemia was not significantly associated with an increased risk of 30-day mortality or
MACE, odds ratios of 1.5 (0.8 to 2.8) and 1.7 (0.9 to 3.0), respectively. However, the presence of
hyperuricemia was associated with an increased risk of late mortality and
MACE, with hazard ratios of 1.4 (1.1 to 1.7) and 1.7 (1.3 to 2.3), respectively. In conclusion, the presence of preoperative
hyperuricemia in vascular patients is a significant predictor of late mortality and
MACE.