Clinical and laboratory features and course of acute myocardial infarction associated with hyperuricemia

Abstract

Objective: To evaluate the impact of hyperuricemia (HU) on the clinical and laboratory characteristics and the course of acute myocardial infarction (AMI).

Material and Methods: A prospective study was conducted involving 85 patients with AMI, divided into two groups: AMI with HU (n=39) and AMI without HU (n=46). HU was defined as a serum uric acid level >420 µmol/L in men and >360 µmol/L in women. Methods included assessment of demographic parameters, risk factors, severity of heart failure (HF) according to the Killip classification, left ventricular ejection fraction (LVEF), and the course of pharmacotherapy.

Results: The groups were comparable in terms of age, sex, and frequency of ST-segment elevation. Patients with HU more frequently presented with Killip class > I (56.4% vs. 28.3%; p=0.008), had lower LVEF (45.8±9.27% vs. 49.6±8.1%; p=0.012), higher serum creatinine levels (118.7±59.1 vs. 87.7±17.6 µmol/L; p=0.001), and lower glomerular filtration rate (GFR) (64.2±14.8 vs. 79.6±19.3 mL/min/1.73 m²; p<0.001). The HU group showed more cases of arterial hypertension (89.7% vs. 63.0%; p=0.004), type 2 diabetes mellitus (61.5% vs. 36.9%; p=0.024), obesity (56.4% vs. 32.6%; p=0.031), and chronic kidney disease (38.5% vs. 10.9%; p=0.003). Urate-lowering therapy was prescribed to only 23.1% of patients with HU.

Conclusions: Hyperuricemia in patients with AMI is associated with a more severe course of the disease, pronounced heart failure, impaired renal function, and a high burden of comorbidities. These findings justify the need for active detection and correction of hyperuricemia in the comprehensive management of AMI patients.