Hyperuricaemia and long-term outcome after hospital discharge in acute heart failure patients

Background: Uric acid (UA) may be involved in chronic heart failure (HF) pathogenesis, entailing a worse outcome. The purpose of this study was to examine the role of hyperuricaemia as a prognostic marker after hospital discharge in acute HF patients. Methods: We studied 212 patients consecutively discharged after an episode of acute HF with LVEF 40%. Blood samples for UA measurement were extracted in the morning prior to discharge. The evaluated endpoints were death and new HF hospitalization. Results: Mean UA levels were 7.4 +/- 2.4 mg/dl (range 1.6 to 16 mg/dl), with 127 (60%) of patients being within the range of hyperuricaemia. Hyperuricaemia was associated with a higher risk of death (n = 48) (HR 2.0, 95% CI 1.1-3.9, p = 0.028), new HF readmission (n = 67) (HR 1.8, 95% CI 1.1-3.1, p = 0.023) and the combined event (n = 100) (HR 1.9, 95% CI 1.2-2.9, p = 0.004). At 24 months, cumulative event-free survival was lower in the two higher UA quartiles (36.9% and 40.7% vs. 63.5% and 59.5%, log rank = 0.006). After adjustment for potential confounders, hyperuricaemia remains an independent risk factor for adverse outcomes (HR 1.6, 95% CI 1.1-2.6, p = 0.02). Conclusions: In hospitalized patients with acute HF and LV systolic dysfunction, hyperuricaemia is a long-term prognostic marker for death and/or new HF readmission. (C) 2006 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.