Correlation between Running Average of Serum Uric Acid Levels and Clinical Course in Secondary Prevention of Coronary Artery Disease.

Objective Long-term uric acid exposure as an independent risk factor for cardiovascular disease remains unclear. This study investigated whether or not the running average serum uric acid (Ra-SUA) value measured after percutaneous coronary intervention (PCI) could be associated with the occurrence of subsequent cardiovascular events. Methods The clinical records of 1,761 patients who underwent successful PCI were retrospectively examined. The Ra-SUA values were calculated by adding consecutive SUA values and dividing them by the number of measurements. Based on the Ra-SUA value during an observation period of up to 10 years after PCI, the patients were divided into 3 groups based on the Ra-SUA: >7.0, 5.5-7.0, and ≤5.5 mg/dL. Among these groups, the incidence of major adverse cardiac events (MACEs) was investigated. Furthermore, patients with Ra-SUA ≤5.5 mg/dL were further classified into 3 groups according to Ra-SUA values to investigate the association with the incidence of MACEs. MACEs were defined as coronary-related death, nonfatal myocardial infarction, and new coronary stenosis of non-culprit lesions. Results A Kaplan-Meier analysis demonstrated that the incidence of MACEs was significantly higher in patients with Ra-SUA >7.0 mg/dL than in the other groups. A multivariate analysis indicated that the Ra-SUA value was significantly correlated with the incidence of MACEs. However, patients with Ra-SUA <4.0 mg/dL had an increased incidence of MACEs compared with patients with Ra-SUA 4.0-5.0 mg/dL. Conclusion High Ra-SUA values may be a predictor of increased recurrence of cardiovascular disease after PCI. There may also be a J-curve association between the incidence of MACEs and Ra-SUA values.