Evidence map›Paper›PMID 33604722›Full record

Observational studyClinical research in cardiology : official journal of the German Cardiac Society2021

The importance of including uric acid in the definition of metabolic syndrome when assessing the mortality risk.

Nicola Riccardo Pugliese, Alessandro Mengozzi, Agostino Virdis, Edoardo Casiglia, Valerie Tikhonoff, Arrigo F G Cicero, Andrea Ungar, Giulia Rivasi, Massimo Salvetti, Carlo M Barbagallo and 31 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Comprehensive Review on Febuxostat for Hyperuricemia with Gout: Insights from Current Practice and Clinical Trials.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Review
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  18. Review
  19. Review
  20. Uric Acid-An Emergent Risk Marker for Thrombosis?Journal of clinical medicine · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors.

Nicola Riccardo Pugliese *Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy. n.r.pugliese88@gmail.com.ORCID http://orcid.org/0000-0002-5473-227X
Alessandro Mengozzi *Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
Agostino VirdisDepartment of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
Edoardo CasigliaDepartment of Medicine, University of Padua, Padua, Italy.
Valerie TikhonoffDepartment of Medicine and Studium Patavinum, University of Padua, Padua, Italy.
Arrigo F G CiceroDepartment of Medical and Surgical Science, Hypertension and Cardiovascular Risk Factors Research Center, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Andrea UngarDepartment of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence, Italy.
Giulia RivasiDepartment of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence, Italy.
Massimo SalvettiDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Carlo M BarbagalloBiomedical Department of Internal Medicine and Specialistics, University of Palermo, Palermo, Italy.
Michele BombelliClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Raffaella Dell'OroClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Berardino BrunoDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Luciano LippaItalian Society of General Medicine, Avezzano, L'Aquila, Italy.
Lanfranco D'EliaDepartment of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy.
Paolo VerdecchiaHospital S. Maria Della Misericordia, Perugia, Italy.
Francesca MallamaciClinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, CNR-IFC, Reggio Calabria, Italy.
Massimo CirilloDepartment of Public Health, University of Naples 'Federico II', Naples, Italy.
Marcello RattazziDepartment of Medicine, Medicina Interna 1°, Ca' Foncello University Hospital, University of Padova, Treviso, Italy.
Pietro CirilloDepartment of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, Aldo Moro University of Bari, Bari, Italy.
Loreto GesualdoDepartment of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, Aldo Moro University of Bari, Bari, Italy.
Alberto MazzaDepartment of Internal Medicine, Hypertension Unit, General Hospital, Rovigo, Italy.
Cristina GiannattasioCardiology IV, A. De Gasperis Department, Health Science Department, Niguarda Ca' Granda Hospital, Milano-Bicocca University, Milan, Italy.
Alessandro MalobertiCardiology IV, A. De Gasperis Department, Health Science Department, Niguarda Ca' Granda Hospital, Milano-Bicocca University, Milan, Italy.
Massimo VolpeHypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy.
Giuliano TocciHypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy.
Georgios GeorgiopoulosFirst Department of Cardiology, Medical School, Hippokration Hospital, University of Athens, Athens, Greece.
Guido IaccarinoDepartment of Advanced Biomedical Sciences, University of Naples 'Federico II', Naples, Italy.
Pietro NazzaroDepartment of Medical Basic Sciences, Neurosciences and Sense Organs, University of Bari Medical School, Bari, Italy.
Gianfranco ParatiDepartment of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS S. Luca Hospital, Lucca, Italy.
Paolo PalatiniDepartment of Medicine, University of Padua, Padua, Italy.
Ferruccio GallettiDepartment of Clinical Medicine and Surgery, University of Naples 'Federico II', Naples, Italy.
Claudio FerriDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Giovambattista DesideriDepartment of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Francesca ViazziDepartment of Internal Medicine, University of Genoa and Policlinico San Martino, Genoa, Italy.
Roberto PontremoliDepartment of Internal Medicine, University of Genoa and Policlinico San Martino, Genoa, Italy.
Maria Lorenza MuiesanDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Guido GrassiClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Stefano Masi *Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
Claudio Borghi *Department of Medical and Surgical Science, Hypertension and Cardiovascular Risk Factors Research Center, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSerum uric acid (SUA) has been depicted as a contributory causal factor in metabolic syndrome (MS), which in turn, portends unfavourable prognosis.

aimWe assessed the prognostic role of SUA in patients with and without MS.

methodsWe used data from the multicentre Uric Acid Right for Heart Health study and considered cardiovascular mortality (CVM) as death due to fatal myocardial infarction, stroke, sudden cardiac death, or heart failure.

resultsA total of 9589 subjects (median age 58.5 years, 45% males) were included in the analysis, and 5100 (53%) patients had a final diagnosis of MS. After a median follow-up of 142 months, we observed 558 events. Using a previously validated cardiovascular SUA cut-off to predict CVM (> 5.1 mg/dL in women and 5.6 mg/dL in men), elevated SUA levels were significantly associated to a worse outcome in patients with and without MS (all p < 0.0001) and provided a significant net reclassification improvement of 7.1% over the diagnosis of MS for CVM (p = 0.004). Cox regression analyses identified an independent association between SUA and CVM (Hazard Ratio: 1.79 [95% CI, 1.15-2.79]; p < 0.0001) after the adjustment for MS, its single components and renal function. Three specific combinations of the MS components were associated with higher CVM when increasing SUA levels were reported, and systemic hypertension was the only individual component ever-present (all p < 0.0001).

conclusionIncreasing SUA levels are associated with a higher CVM risk irrespective of the presence of MS: a cardiovascular SUA threshold may improve risk stratification.

Indexed as

BiomarkersCardiovascular DiseasesCause of DeathFemaleFollow-Up StudiesHumansItalyMaleMetabolic SyndromeMiddle AgedPrognosisRetrospective StudiesRisk FactorsSurvival RateUric AcidBiomarkersUric AcidCardiovascular mortalityMetabolic syndromePrognosisSerum uric acid

Identifiers

PMID33604722
PMCPMC8238697

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.