Vol. 43 | No. 2 | July-December 2015 Back

Open Access

Hyperuricemia and Its Prognostic Value in Patients with Rheumatic Heart Disease

Paolo P. Villanueva, Ana Beatriz D. Medrano, Noe A. Babilonia
Dec 2015 DOI 10.69944/pjc.65cc766182

Abstract

BACKGROUND: Hyperuricemia has recently been linked to cardiovascular diseases, such as coronary artery disease and heart failure, as a marker of disease activity for prognostication. However, there are no studies correlating uric acid levels with heart failure among patients with rheumatic heart disease (RHD). 

METHODOLOGY: This is a prospective cohort study correlating the increase in uric acid levels with the development of heart failure symptoms in patients with RHD. Fifty-one subjects with RHD and with good functional capacity (New York Heart Association [NYHA] Class I) were included in the study. The subjects were followed up for one year, in which 24 subjects fulfilled the Framingham criteria for heart failure and 27 remained in NYHA Class I. 

RESULTS:Mean baseline uric acid levels were similar between the two groups (heart failure 390±82 umol/L; no heart failure 388±134 umol/L; p=0.964). The mean difference between the baseline and endpoint serum uric acid levels in those without heart failure was not statistically significant (baseline 388±134 umol/L vs. endpoint 391±134 umol/L; p=0.77). In those who developed heart failure, the mean endpoint serum uric acid levels became significantly higher from baseline (baseline 390±82 umol/L vs. endpoint 437±106umol/L; p=0.0007). There was a significantly greater increase in serum uric acid levels in patients who eventually developed heart failure symptoms (heart failure 47.1±59.1 umol/L vs. no heart failure 2.6±46 umol/L; p=0.004). An increase in serum uric acid level by 30 umol/L from baseline had a sensitivity of 70.83% and a specificity of 74.07% for predicting the occurrence of heart failure symptoms. 

CONCLUSION: Increasing serum uric acid levels are associated with the development of heart failure symptoms in patients with RHD. 

KEYWORDS: rheumatic heart disease, mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, congestive heart failure, uric acid, hyperuricemia 

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