Examining the Link between Serum Uric Acid Levels and Coronary Artery Disease (CAD) Severity in Patients Undergoing Elective Coronary Angiography

Abstract

Background: High serum uric acid (SUA) is prevalent in subjects with obesity, renal disease, glucose intolerance, hyperlipidemia, hypertension, and atherosclerosis, all of which are established risk factors for coronary artery disease (CAD). Uric acid is a significant antioxidant in the initial atherosclerosis but can potentially switch to a pro-oxidant in advanced cases, depending on the factors like tissue acidity and oxidative stress. This paradoxical behavior, in addition to its association with inflammation and insulin resistance—a characteristic of metabolic syndrome—requires further investigation. Therefore, the aim of this study was to examine the relationship between SUA levels and the presence and severity of CAD.

Study design: An observational cohort study.

Duration and place of study: This study was conducted in People’s University of Medical and Health Sciences Nawabshah (PUMHS) from January 2023 to January 2024.

Objective: To explore the relationship between serum uric acid level and the presence and seriousness of coronary artery disease (CAD) in individuals undergoing elective coronary angiography

Methodology: This cohort study of 200 consecutive hospitalized patients with CAD symptoms, all undergoing elective coronary angiography, was observational. Patients were divided into CAD-positive (with stenosis) or CAD-negative (without stenosis) groups according to their angiographic findings. CAD severity was graded using the Gensini grading system, and two blinded cardiologists assessed the angiograms. Risk factors like age, gender, smoking, diabetes, hypertension, hyperlipidaemia, family history, and hyperuricemia were documented and biochemical tests such as lipid profiles, fasting glucose, and uric acid were performed employing routine methods after 10 hours.

Results: Observational cohort study included 200 patients who underwent coronary artery disease (CAD) assessment via coronary angiography. Out of these, 175 had CAD, whereas 25 did not. CAD patients had significantly higher levels of blood uric acid compared to non-CAD patients (358.23 µmol/L vs. 251.32 µmol/L, p < 0.001). In accordance with logistic regression analysis, elevated levels of uric acid, smoking, decreased levels of HDL-C, and hypertension were all significantly related with the presence of CAD. These findings reflect a significant correlation between elevated serum uric acid and the presence and seriousness of CAD.

Conclusion: In short, serum uric acid level was significantly correlated with the presence and seriousness of coronary artery disease (CAD).