Abstract

Background. No study has examined the effect of low serum uric acid (SUA) concentrations on mortality in hypertrophic cardiomyopathy (HCM) patients. The aim of the present study was to assess the relations between both low and high SUA concentrations and the risk of mortality across the full range of SUA concentrations in a retrospective cohort of HCM patients.

Methods. A total of 454 HCM patients were enrolled in the study, and SUA concentrations were measured at baseline. The primary and secondary endpoints were all-cause mortality and HCM-related mortality, respectively. The associations between SUA concentrations and endpoints were analysed.

Results. During a median follow-up of 3.8 years, there were 80 (17.6%) all-cause mortality events, and 52 of them (11.5%) were ascribed to HCM-related mortality. Patients with SUA concentrations of 250–350 µmol/L had the lowest all-cause mortality rate (11.8%) and HCM-related mortality rate (5.0%). Both low and high SUA concentrations were associated with increased all-cause and HCM-related mortality. Adjusted HRs were 2.52 (95% CI 1.13–5.61, p = 0.024) and 4.86 (95% CI 1.74–13.58, p = 0.003) for all-cause mortality and HCM-related mortality in the lowest SUA group (<250 µmol/L) when compared with the reference group (250–350 µmol/L), respectively. The corresponding HRs in the highest SUA group (≥450 µmol/L) were 2.73 (95% CI 1.42–5.23, p = 0.003) and 4.14 (95% CI 1.70–10.13, p = 0.002), respectively.

Conclusions. Both low and high SUA concentrations were significantly associated with increased risk of all-cause mortality and HCM-related mortality, which supported a U-shaped association between SUA concentrations and mortality in HCM patients.

摘要

背景。没有研究检查过低血清尿酸（SUA）浓度对肥厚型心肌病（HCM）患者死亡率的影响。本研究的目的是评估HCM患者回顾性队列中低和高SUA浓度与整个SUA浓度范围内死亡风险之间的关系。

方法。研究共纳入454名HCM患者，并在基线时测量SUA浓度。主要终点和次要终点分别是全因死亡率和HCM相关死亡率。分析了SUA浓度与终点之间的关联。

结果。在3.8年的中位随访期间，发生了80起（17.6％）全因死亡率事件，其中52起（11.5％）与HCM相关的死亡率有关。SUA浓度为250–350 µmol / L的患者全因死亡率最低（11.8％），与HCM相关的死亡率最低（5.0％）。低和高SUA浓度均与全因病和与HCM相关的死亡率增加相关。 最低SUA组（<250μmol/  min ）的全因死亡率和HCM相关死亡率的校正后HRs为2.52（95％CI 1.13–5.61，p = 0.024）和4.86（95％CI 1.74–13.58，p = 0.003）。 L）与参考组（250–350 µmol / L）分别比较。最高SUA组（≥450μmol/ L）的相应HRs为2.73（95％CI 1.42-5.23，p = 0.003）和4.14（95％CI 1.70–10.13，p  = 0.002）。

结论。高和低SUA浓度均与全因死亡率和HCM相关死亡率的增加风险显着相关，这支持SUA浓度与HCM患者死亡率之间呈U型关联。