Serum uric acid and drug-eluting stent implantation for coronary bifurcated lesions.

Background: The aim of this study is to investigate the effect of hyperuricemia on prognosis of drug-eluting stent implantation for coronary bifurcated lesions and the value of uric acid levels in predicting the prognosis.

Methods: Patients with coronary bifurcation lesions treated with drug-eluting stent implantation were retrospectively enrolled. The clinical, interventional and follow-up data were analyzed.

Results: Totally, 308 patients were enrolled and were divided into three groups according to the uric acid levels: group Q1 (N.=105), Q2 (N.=101), and Q3 (N.=102). Before PCI, the stenosis rate was 0.85 (0.80, 0.90) for the main coronary artery and 0.50 (0.50, 0.50) for the branch artery. After PCI and stent deployment, the arterial stenosis rate was 0.20 (0.20, 0.20) for the main coronary artery and 0.50 (0.50, 0.50) for the branch artery. At 36-month follow-up, seven patients died of different reasons, with five patients in group Q1, one in group Q2, and one in group Q3, 96 patients were readmitted for treatment of angina pectoris, with 18 in Q1 group, 29 in Q2 group, and 49 in Q3 group. Twenty-seven patients experienced revascularization because of deterioration of the condition, including six patients in group Q1, seven in group Q2, and 14 in group Q3. After correction of the confounding factors, the readmission rate of angina pectoris was significantly (P<0.001) increased with the increase of the uric acid level: Q3 vs. Q1 (220.47/1000 vs. 66.69/1000 person years, HR 3.65, 95% CI 1.92-6.96) and Q2 vs. Q1 (113.76/1000 vs. 66.69/1000 person years, HR 2.20,95% CI 1.16-4.18).

Conclusions: Increased uric acid level is an independent risk factor for cardiogenic readmission rather than for all-cause mortality and revascularization after drug-eluting stent implantation for patients with coronary bifurcation lesions.