Uric acid in patients with angiographically documented coronary heart disease

Objective-High serum uric acid levels have been associated with coronary heart disease (CHD). Hyperuricaemia is known to be related to several of the established aetiologic risk factors of CHD, such as obesity, insulin resistance, raised serum triglycerides, and hypertension, but it is still uncertain whether this relationship may cause the association between CHD and uric acid. We have investigated whether uric acid was an independent risk factor for CHD. Methods and results-Two-hundred and ninety patients with suspected CHD referred to elective coronary angiography were enrolled. The association between angiographically detected coronary stenosis > 50% in one or more of the 3 major coronary arteries and uric acid levels was examined. A significant association between high uric acid levels and the presence of one or more diseased vessels in women (p = 0.02) was observed, while no association was found in men (p = 0.25). After adjustment for several possible confounders such as smoking, triglycerides, HDL cholesterol, and a diagnosis of diabetes mellitus the association among women disappeared. Conclusion-The results indicate that uric acid should not be viewed as an independent risk factor for CHD, but more likely as a biological marker reflecting other causative parameters.