Plasma Uric Acid as a Prognostic Marker in Patients With Hypertrophic Cardiomyopathy

Background: Uric acid (UA) has been shown to be an independent risk factor for various cardiovascular diseases. However, its significance in hypertrophic cardiomyopathy (HCM) has not yet been evaluated. The objective of the present study was to evaluate clinical implications of plasma UA levels on the prognosis of patients with HCM. Methods: A total of 588 adult patients with HCM were enrolled at FuWai Hospital from 1999-2011 and followed until 2014. The plasma levels of UA were measured at enrollment. Results: During the follow-up of 5.2 +/- 2.4 years, 44 (7.5%) patients had cardiovascular-related deaths, and 100 (17.0%) patients had cardiac events. Compared with the first tertile of UA concentration (< 284.6 mu mol/L), patients in the highest tertile (> 358.7 mu mol/L) had a higher risk for the development of adverse events: cardiovascular death (adjusted hazard ratio [HR], 3.10; 95% confidence interval [CI], 1.37-7.04; P = 0.007), all-cause mortality (adjusted HR, 2.33; 95% CI, 1.11-4.89; P = 0.025), cardiac events (adjusted HR, 4.20, 95% CI, 2.38-7.42; P < 0.001), heart failure events (adjusted HR, 3.46; 95% CI, 1.86-6.45; P < 0.001), and arrhythmic events (adjusted HR, 9.19; 95% CI, 2.40-35.25; P = 0.001). Similarly, the continuous variable of UA (for every 1 mg/dL higher concentration) was also an independent predictor for adverse outcomes: cardiovascular death (adjusted HR, 1.29; 95% CI, 1.11-1.49; P = 0.001), all-cause mortality (adjusted HR, 1.23; 95% CI, 1.07-1.41; P = 0.004), cardiac events (adjusted HR, 1.27; 95% CI, 1.15-1.41; P < 0.001), heart failure events (adjusted HR, 1.19; 95% CI, 1.06-1.33; P = 0.003), and arrhythmic events (adjusted HR, 1.60; 95% CI, 1.30-1.98; P < 0.001). Conclusions: Our results indicate that UA is an independent predictor of adverse outcomes in patients with HCM.