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URIC ACID AS A PROGNOSTIC INDICATOR TO ESTIMATE THE RISK OF IN-HOSPITAL MORTALITY AND MAJOR ADVERSE CARDIAC EVENTS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Khaled Kamal Layka*, Akram Jahjah, Yousef Zrek
Background : Uric acid (UA) is a risk factor associated with an increased incidence of cardiovascular disease, and an indicator of oxidative stress that plays a fundamental role in the pathogenesis of acute myocardial infarction (AMI) and it's subsequent consequences .Objective: to assess the prognostic value of UA as an indicator of in-hospital complications and mortality in patients with AMI. Materials and methods: Study sample included patients with AMI admitted to the cardiac care unit at Tishreen University Hospital-Lattakia –Syria from September 2019 to September 2020. Serum UA tests were performed for all patients, in addition to all required investigative and therapeutic procedures. Study sample was divided into two groups according to the admission value of uric acid (high uric acid, and normal uric acid). Results: 98 patients were included, 74 were male (76%). Means of age, Hemoglobin, Urea, and glucose of high uric acid group were higher and the prevalence of diabetes and hypertension was higher. UA values were positively correlated with GRACE scores (r=0.6,P<0.001). According to multivariate analysis, high UA was associated with an increased risk of mortality (OR 3.3 ,P=0.04), cardiogenic shock(CS) (OR 5.6 ,P=0.04), acute heart failure(AHF) (OR 3.8 ,P=0.01) and systolic dysfunction (OR 4,97 ,P=0.01) . There was an inverse correlation between changes in UA level (between day1 and day3 ) and left ventricular ejection fraction(r=-0.42, P<0.001). Conclusions: high UA on admission and increased UA level between day 1 and day 3 were predictive indicators for mortality and complications (CS and AHF) in patients with AMI.[Full Text Article]