Plasma xanthine oxidoreductase (XOR) activity in patients who require cardiovascular intensive care.

Abstract

Hyperuricemia is known to be associated with adverse outcomes in cardiovascular intensive care patients, but its mechanisms are unknown. A total of 569 emergency department patients were prospectively analyzed and assigned to intensive care (ICU group, n = 431) or other departments (n = 138). Uric acid (UA) levels were significantly higher in the intensive care patients (6.3 [5.1-7.6] mg/dl vs. 5.8 [4.6-6.8] mg/dL). The plasma xanthine oxidoreductase (XOR) activity in the ICU group (68.3 [21.2-359.5] pmol/h/mL) was also significantly higher than that in other departments (37.2 [15.1-93.6] pmol/h/mL). Intensive care patients were divided into three groups according to plasma XOR quartiles (Q1, low-XOR, Q2/Q3, normal-XOR, and Q4, high-XOR group). A multivariate logistic regression model showed that lactate (per 1.0 mmol/L increase, OR 1.326; 95%, CI 1.166-1.508, p < 0.001) and the Acute Physiology and Chronic Health Evaluation II score (per 1.0 point increase, OR 1.095, 95% CI 1.034-1.160, p = 0.002) were independently associated with the high-XOR group. In-hospital mortality was significantly higher in the high-XOR group (n = 28, 26.2%) than in the normal- (n = 11, 5.1%) and low- (n = 9, 8.3%) XOR groups. The high-XOR group (vs. normal-XOR group) was independently associated with the in-hospital mortality (OR 2.934; 95% CI 1.170-7.358; p = 0.022). Serum UA levels and plasma XOR activity were high in patients admitted to intensive care. The enhanced XOR activity may be one of the mechanisms under which hyperuricemia was associated with adverse outcomes in patients requiring cardiovascular intensive care.

• Authors: Yusaku Shibata, Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kazutaka Kiuchi, Kenichi Tani, Takayo Murase, Takashi Nakamura, Nobuaki Kobayashi, Noritake Hata, Kuniya Asai, Wataru Shimizu
• Journal: Heart and vessels (Heart Vessels) Vol. 35 Issue 10 Pg. 1390-1400 (Oct 2020) ISSN: 1615-2573 [Electronic] Japan
• PMID: 32342210 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Uric Acid
• Xanthine Dehydrogenase

Topics

• APACHE
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Cardiovascular Diseases (blood, diagnosis, mortality, therapy)
• Emergency Service, Hospital
• Female
• Hospital Mortality
• Humans
• Hyperuricemia (blood, diagnosis, mortality, therapy)
• Intensive Care Units
• Male
• Middle Aged
• Prognosis
• Prospective Studies
• Risk Assessment
• Risk Factors
• Up-Regulation
• Uric Acid (blood)
• Xanthine Dehydrogenase (blood)