尿酸与心血管疾病患者发生心力衰竭的风险。

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Nutrition Metabolism and Cardiovascular Diseases Pub Date : 2024-09-17 DOI:10.1016/j.numecd.2024.09.012

Na Li , Yaqi Li , Liufu Cui , Rong Shu , Jiaoyan Li , Haicheng Song , Jierui Wang , Shuohua Chen , Chenrui Zhu , Maoxiang Zhao , Xiang Gao , Tong Liu , Shouling Wu

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引用次数: 0

摘要

背景和目的：尿酸与普通人群患心力衰竭的风险呈正相关。然而，高尿酸血症是否是心力衰竭的独立风险因素，是否会进一步增加已患心血管疾病（CVD）人群的心力衰竭风险，目前仍不清楚。本研究旨在评估尿酸与已确诊心血管疾病患者发生心力衰竭之间的关系：研究纳入了开滦研究中18,438名已确诊心血管疾病但基线时无心力衰竭的成年人。心力衰竭病例通过医疗记录确定。应用特定病因的考克斯比例危险回归模型，根据尿酸三元组估计心衰的危险比（HRs）和95%置信区间（CIs）。在中位 6.1 年的随访期间，我们共发现了 1215 例心衰病例。尿酸越高，发生心力衰竭的风险越高，最后一个三分位数与第一个三分位数的调整HR值为1.50（95%CI：1.30-1.73）。尿酸浓度较高与冠心病、心房颤动和缺血性中风患者心力衰竭风险增加有关，但与出血性中风患者无关。此外，与射血分数保留型心力衰竭相比，尿酸与心力衰竭风险之间的关联在射血分数降低亚型心力衰竭患者中更为明显：结论：在心血管疾病患者中，尿酸与心力衰竭风险呈剂量反应正相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Uric acid and risk of incident heart failure in individuals with cardiovascular disease

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Uric acid and risk of incident heart failure in individuals with cardiovascular disease

Background and aims

Uric acid has been positively associated with the risk of developing heart failure in the general population. Nevertheless, it remains unclear whether hyperuricemia is an independent risk factor for heart failure and further contributes to the risk of heart failure among the already at-risk cardiovascular disease (CVD) population. This study aimed to evaluate the association between uric acid and incident heart failure in individuals with established CVD.

Methods and results

Included were 18,438 adults with established CVD but free of heart failure at baseline, from the Kailuan Study. Incident heart failure cases were ascertained by medical records. Cause-specific Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) of heart failure according to uric acid tertiles. Over a median follow-up of 6.1 years, we identified 1215 incident heart failure cases. Higher uric acid was associated with a higher risk of incident heart failure, with adjusted HR for the last vs. first tertile of 1.50 (95%CI:1.30–1.73). Higher uric acid concentrations were associated with an increased risk of heart failure in individuals with coronary heart disease, atrial fibrillation, and ischemic stroke, but not in those with hemorrhagic stroke. Moreover, the observed association between uric acid and heart failure risk was more pronounced in individuals diagnosed with heart failure with reduced ejection fraction subtype compared with heart failure with preserved ejection fraction.

Conclusions

In individuals with CVD, uric acid was positively associated with the risk of heart failure, in a dose-response manner.

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来源期刊

Nutrition Metabolism and Cardiovascular Diseases 医学-内分泌学与代谢

CiteScore

6.80

自引率

2.60%

发文量

332

审稿时长

57 days

期刊介绍： Nutrition, Metabolism & Cardiovascular Diseases is a forum designed to focus on the powerful interplay between nutritional and metabolic alterations, and cardiovascular disorders. It aims to be a highly qualified tool to help refine strategies against the nutrition-related epidemics of metabolic and cardiovascular diseases. By presenting original clinical and experimental findings, it introduces readers and authors into a rapidly developing area of clinical and preventive medicine, including also vascular biology. Of particular concern are the origins, the mechanisms and the means to prevent and control diabetes, atherosclerosis, hypertension, and other nutrition-related diseases.