Prognostic role of the serum uric acid-to-serum creatinine ratio in patients with st-elevation myocardial infarction and multivessel coronary artery disease.

Background: The aim of this study was to investigate whether serum uric acid to serum creatinine ratio (SUA/SCr) predicts the early major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with ST elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVCAD).

Methods: This study was designed retrospectively and included 572 patients with a mean age of 61.9 ± 12.3 years who presented with STEMI and had MVCAD. The patients were divided into 2 groups as those with and without MACCEs, taking into account the 30-day follow-up period. Serum uric acid, and serum creatinine were obtained at admission. The SUA/SCr of all patients were calculated and evaluated the relationship of SUA/SCr with the 30-day MACCEs.

Results: During the mean 27.0 ± 7.7 day follow-up period, 58 (10.1%) patients died, and 84 patients (14.7%) suffered MACCEs. According to multivariable cox regression analysis, advanced age (HR: 1.020, p = 0.028), smoking (HR: 2.513, p = 0.001), lower left ventricular ejection fraction (HR: 0.962, p = 0.001), TIMI < 3 flow (HR: 0.425, p < 0.001), higher syntax score (HR: 1.067, p < 0.001), and higher SUA/SCr (HR: 1.1029, p = 0.011) independently predicted the 30-day MACCEs. The area under the curve for SUA/SCr was 0.606 with a p value of 0.002. The Kaplan Meier curves represented that high-risk patients with SUA/SCr greater than 4.58 had significantly higher MACCEs than low-risk group during the follow up period after index hospitalization (p = 0.001).

Conclusions: Newly defined promising oxidative and inflammatory biomarker, SUA/SCr can be a potential predictor of MACCEs within 30 days and decision-making treatment in STEMI and MVCAD patients.