Background There is a growing body of evidence that suggests that serum uric acid (sUA) is associated with a variety of comorbidities in gout, most notably cardiovascular (CV) and renal disease. A better understanding of this association is important to fully describe the overall burden of hyperuricemia and to describe the full clinical impact that this condition has on patients with increased CV risk.
Objectives To evaluate the association between sUA levels and calculated CV risk scores using the Systematic COronary Risk Evaluation (SCORE) and SCORE-high-density lipoprotein (HDL) cholesterol (C) (whereby total C and HDL-C are considered independent variables) algorithms.
Methods Post-hoc analysis of the EURIKA study database, which was a multicenter, multinational, cross-sectional study, involving primary care and outpatient clinics involved in primary prevention from 12 European countries between May 2009 and January 2010. Patients enrolled in the EURIKA study (aged ≥50 years and having ≥1 selected CV risk factor), with a valid determination of sUA were considered for this post hoc analysis. Multivariate linear regression models were fitted to assess the association between sUA levels and CV risk scores, including selected potential confounders (country, number of comorbidities, number of CV risk factors, at least one lipid-lowering drug and/or at least one anti-hypertensive drug).
Results The full EURIKA population included 7580 patients, of whom 7531 had a valid determination of an sUA level. The mean (SD) age of the patients was 63.2 (9.0) and 51.7% were female. sUA was significantly associated with CV risk scores (Pearson correlation coefficient 0.17 [95% CI 0.15–0.19; p<0.0001] for SCORE and 0.23 [95% CI 0.21–0.25; p<0.0001] for SCORE-HDL) in the entire analysis population. After adjustment for selected potential confounders, sUA was confirmed as a factor significantly associated with increased CV risk scores (SCORE, p<0.0001; SCORE-HDL, p<0.0001).
Conclusions Based on this multinational European study, elevated sUA levels were shown to be an associated factor for increased CV risk. Awareness of SUA levels may be an important aspect of CV risk assessment. Further examination in larger patient populations is warranted to assess the impact of sUA levels in those having or who may be susceptible to CV disease.
Krishnan E, Baker JF, Furst DE and Schumacher HR. Arthritis Rheum 2006;54:2688–2696.
Krishnan E, Svendsen K, Neaton JD, Grandits G, Kuller LH, MRFIT Research Group. Arch Intern Med 2008;168(10):1104–1110.
Richette P, Clerson P, Périssin L, Flipo RM, Bardin T. Ann Rheum Dis 2015;74(1):142–147.
Acknowledgements This study was funded by AstraZeneca. Editorial support was provided by PAREXEL and funded by AstraZeneca.
Disclosure of Interest C. Borghi Consultant for: Amgen, Sanofi, Menarini, Servier, Novartis, Eli Lilly, Speakers bureau: Amgen, Sanofi, Servier, Novartis, St. Jude Medical, J. Nuevo Employee of: AstraZeneca, J. Medina Employee of: AstraZeneca, F. Tubach Grant/research support from: AstraZeneca