The association of perioperative serum uric acid variation with in-hospital adverse outcomes in coronary artery bypass grafting patients.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Frontiers in Cardiovascular Medicine Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI:10.3389/fcvm.2024.1364744
Junyi Gao, Yi Cheng
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引用次数: 0

Abstract

Background: Previous studies proposed the predictive value of baseline serum uric acid (SUA) in the prognosis of coronary artery bypass grafting (CABG) patients. The association of perioperative SUA variation with in-hospital adverse outcomes in CABG patients is unknown.

Methods: A total of 2,453 patients were included in the study and were divided into four groups (G1-G4) according to perioperative SUA variation (ΔSUA) (G1, ΔSUA ≤ -90 μmol/L; G2, -90 μmol/L < ΔSUA < 0; G3, 0 ≤ ΔSUA < 30 μmol/L; G4, 30 μmol/L ≤ ΔSUA.) The basic characteristics and incidence of adverse outcomes were compared between the groups in the overall population and the subgroups. Multivariate logistic regression was performed to explore the association between perioperative SUA increases and adverse outcomes, and receiver operating characteristic analysis was used to obtain the cutoff value of SUA increases.

Results: The patients had a mean age of 60.9 years and the majority were males (76.7%). In the group with the most significant increase in SUA (G4), incidences of in-hospital all-cause death and fatal arrhythmia were higher than in other groups in the overall population and the subgroups. Multivariate logistic regression showed that an increase in the SUA level of ≥30 µmol/L was significantly associated with in-hospital all-cause death and fatal arrhythmia, independent of the baseline SUA level and renal function. This association was significant in most subgroups for in-hospital fatal arrhythmia and in the ≥60 years, myocardial infarction, and female subgroups for in-hospital all-cause death. The cutoff values of SUA increases in the overall population were 54.5 µmol/L for in-hospital all-cause death and 42.6 µmol/L for in-hospital fatal arrhythmia.

Conclusions: The perioperative SUA increase significantly correlated with a higher incidence of in-hospital all-cause death and fatal arrhythmia in CABG patients, independent of the baseline SUA level and renal function. Perioperative SUA variation may provide complementary information in the identification of patients potentially at risk.

冠状动脉搭桥术患者围手术期血清尿酸变化与院内不良预后的关系。
背景:先前的研究提出了基线血清尿酸(SUA)对冠状动脉旁路移植术(CABG)患者预后的预测价值。围手术期 SUA 变化与 CABG 患者院内不良预后的关系尚不清楚:研究共纳入 2,453 例患者,并根据围手术期 SUA 变化(ΔSUA)将其分为四组(G1-G4)(G1,ΔSUA ≤ -90 μmol/L;G2,-90 μmol/L 结果:患者平均年龄为 60 岁,围手术期 SUA 变化与 CABG 患者院内不良预后的关系尚不清楚:患者的平均年龄为 60.9 岁,大多数为男性(76.7%)。在 SUA 升高最明显的组别(G4)中,院内全因死亡和致命性心律失常的发生率高于总体和亚组中的其他组别。多变量逻辑回归显示,SUA水平升高≥30 µmol/L与院内全因死亡和致命性心律失常显著相关,与基线SUA水平和肾功能无关。在大多数亚组中,这种关联与院内致命性心律失常显著相关;在≥60 岁、心肌梗死和女性亚组中,这种关联与院内全因死亡显著相关。总体人群的 SUA 升高临界值为:院内全因死亡为 54.5 µmol/L,院内致命性心律失常为 42.6 µmol/L:结论:围手术期 SUA 升高与 CABG 患者较高的院内全因死亡和致命性心律失常发生率显著相关,与基线 SUA 水平和肾功能无关。围术期 SUA 变化可为识别潜在风险患者提供补充信息。
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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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