[Correlation of serum uric acid levels with coronary flow in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention].

OBJECTIVE: To explore the association of the uric acid levels and coronary blood flow in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

METHODS: A total of 276 STEMI patients undergoing primary PCI were enrolled and divided into 2 groups based upon the Thrombolysis in Myocardial Infarction (TIMI) flow grade. No-reflow was defined as TIMI Grade 0, 1 and 2 flows. The association of uric acid levels on admission with TIMI flow grade after PCI was assessed by multivariate Logistic regression. Major adverse cardiac events (MACE) were defined as death, non-fatal myocardial infarction and need for repeat percutaneous revascularization or coronary artery bypass grafting.

RESULTS: The uric acid level was significantly higher in the no-reflow group (n = 57) than that of the normal-flow group (n = 219, 372 ± 111 vs 303 ± 102, P < 0.01). In-hospital MACEs were significantly higher in the patients with no reflow (8.8% vs 1.8%, P = 0.016). A uric acid level ≥ 345 mmol/L measured on admission had a 61.2% sensitivity and 77.5% specificity in predicting no-reflow at ROC curve analysis. At multivariate analyses, high plasma uric acid (OR 1.01, 95%CI 1.01 - 1.01, P < 0.01), neutrophil count (OR 1.02, 95%CI 1.00 - 1.06, P < 0.01), admission plasma glucose (OR 1.14, 95%CI 1.08 - 1.21, P < 0.01), time from pain to PCI (OR 1.67, 95%CI 0.46 - 5.97, P = 0.012), pre PCI thrombus score ≥ 4 (OR 2.67, 95%CI 1.29 - 5.13, P = 0.008), collateral circulation grade ≤ 1 (OR 1.86, 95%CI 1.27 - 2.73, P = 0.008), and Killip classes (OR 2.01, 95%CI 1.01 - 3.94, P = 0.042) were independent predictors of no-reflow post primary PCI.

CONCLUSIONS: The plasma level of uric acid on admission is a strong and independent predictor of poor coronary blood flow following at post-primary PCI among STEMI patients. Uric acid levels may be a useful biomarker of risk stratification.