DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20203433

Evaluating the relationship between serum uric acid levels with Killip classification suggestive of left heart failure in acute myocardial infarction

Piyush Gosar, Sutakshee Sonwani, Pravi Gosar, Bhawana Rani

Abstract


Background: Present evidence shows that increased uric acid level is a negative prognostic factor in patients with moderate to severe heart failure. A study has highlighted a correlation between serum uric acid levels and Killip class in patients of acute myocardial infarction (AMI). Aim of this study the relationship between serum uric acid level and Killip classification in patients with AMI.

Methods: Sixty patients with AMI were studied prospectively in Department of Medicine/ Department of Cardiology, JA Group of Hospitals between 2016-2018. Patients were grouped based on the Killip class. Age, sex, history of smoking, alcohol consumption, hypertension and diabetes were recorded. Serum uric acid level were measured on Day 1, 3 and 5, which was compared with Killip class.

Results: Majority of the patients were males (65%) and had age between (28.3%) 51-60 years. No significant association was obtained between any risk factors of AMI and Killip’s class (p>0.05). Serum uric acid levels were significantly higher in Killip grade III (7.80±3.57) as compared to Killip’s grade II (6.64±2.88) and I (6.30±2.33) (p=0.014). Majority of the patients with Killip’s grades I and II, had uric acid level ≤7.0 mg/dl (n=18 and n=9 respectively) (p=0.040). Serum uric acid was equally distributed among different types of killip’s grades between patients who expired and survived. (p>0.05).

Conclusions: Serum uric acid levels has been found to be well correlated with Killip classification in patients with AMI. Combination of Killip class and serum uric acid level after AMI is a good predictor of mortality after AMI.


Keywords


Complications, Heart failure, Risk factors, Serum uric acid level

Full Text:

PDF

References


Kenchaiah S, Narula J, Vasan RS. Risk factors for heart failure. Med Clin North Am. 2004;88:1145-72.

Miller WL, Hartman KA, Burritt MF. Serial biomarker measurements inambulatory patients with chronic heart failure: the importance of change overtime. Circulation. 2007;116:249-57.

Khot UN, Jia G, Moliterno DJ. Prognostic importance of physical examination for heart failure in non-ST-elevation acute coronary syndromes. JAMA. 2003;290:2174-218.

Kojima S, Sakamoto T, Ishihara M. Prognostic usefulness of serum uric acid after acute myocardial infarction (Japanese Acute Coronary Syndrome Study). Am J Cardiol. 2005;96:489-95.

Laurence S, Sperling JI, Mechanick IJ. The CardioMetabolic Health Alliance Working Toward a New Care Model for the Metabolic Syndrome. J Am Coll Cardiol. 2015;66:1050-67.

Kahn HS, Valdez R. Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration. Am J Clin Nutr. 2003;78:928-34.

Frisch DR, Giedrimas E, Mohanavelu S. Predicting irreversible left ventricular dysfunction after acute myocardial infarction. Am J Cardiol. 2009;103:1206.

Reynolds HR, Hochman JS. Cardiogenic shock: Current concepts and improving outcomes. Circulation. 2008;117:686.

Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit. A two-year experience with 250 patients. Am J Cardiol. 1967;20:457-63.

Harris P, Jenner FP, Kumar S. Serum uric acid as a marker of left ventricular failure in acute myocardial infarction. IOSR J Dental Med Scien. 2015;14(11):102-9.

Nadkar MY, VI Jain. Serum Uric Acid in Acute Myocardial Infarction. J Assoc Physicians India. 2008 Oct;56:759-62.

Jularattanaporn V, Krittayaphong R, Boonyasirinant T, Udol K, Udompunurak S. Prevalence of Hyperuricemia in Thai Patients with Acute Coronary Syndrome. Thai Heart J. 2008;21:86-92.

Padma V, Banupriya A. Serum uric acid levels in acute myocardial infarction. Int J Adv Med. 2017;4:1010-3.

Gazi E, Temiz A, Altun B, Barutçu A, Bekler A, Güngör O, et al. The association between serum uric acid level and heart failure and mortality in the early period of ST-elevation acute myocardial infarction. Turk Kardiyol Dern Ars. 2014;42(6):501-8.

Behera SK, Samal AK. Study of serum uric acid level as a prognostic marker in acute ST elevation myocardial infarction patients. Int J Adv Med. 2018;5:592-6.