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Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013

AIMS: To investigate whether serum uric acid predicts adverse outcomes in persons with indices of diastolic dysfunction in a general population. METHODS AND RESULTS: We performed a prospective cohort study among 1460 women and 1480 men from 1994 to 2013. Endpoints were all‐cause mortality, incident...

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Autores principales: Norvik, Jon V., Schirmer, Henrik, Ytrehus, Kirsti, Storhaug, Hilde M., Jenssen, Trond G., Eriksen, Bjørn O., Mathiesen, Ellisiv B., Løchen, Maja‐Lisa, Wilsgaard, Tom, Solbu, Marit D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396037/
https://www.ncbi.nlm.nih.gov/pubmed/28451452
http://dx.doi.org/10.1002/ehf2.12134
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author Norvik, Jon V.
Schirmer, Henrik
Ytrehus, Kirsti
Storhaug, Hilde M.
Jenssen, Trond G.
Eriksen, Bjørn O.
Mathiesen, Ellisiv B.
Løchen, Maja‐Lisa
Wilsgaard, Tom
Solbu, Marit D.
author_facet Norvik, Jon V.
Schirmer, Henrik
Ytrehus, Kirsti
Storhaug, Hilde M.
Jenssen, Trond G.
Eriksen, Bjørn O.
Mathiesen, Ellisiv B.
Løchen, Maja‐Lisa
Wilsgaard, Tom
Solbu, Marit D.
author_sort Norvik, Jon V.
collection PubMed
description AIMS: To investigate whether serum uric acid predicts adverse outcomes in persons with indices of diastolic dysfunction in a general population. METHODS AND RESULTS: We performed a prospective cohort study among 1460 women and 1480 men from 1994 to 2013. Endpoints were all‐cause mortality, incident myocardial infarction, and incident ischaemic stroke. We stratified the analyses by echocardiographic markers of diastolic dysfunction, and uric acid was the independent variable of interest. Hazard ratios (HR) were estimated per 59 μmol/L increase in baseline uric acid. Multivariable adjusted Cox proportional hazards models showed that uric acid predicted all‐cause mortality in subjects with E/A ratio <0.75 (HR 1.12, 95% confidence interval [CI] 1.00–1.25) or E/A ratio >1.5 (HR 1.51, 95% CI 1.09–2.09, P for interaction between E/A ratio category and uric acid = 0.02). Elevated uric acid increased mortality risk in persons with E‐wave deceleration time <140 ms or >220 ms (HR 1.46, 95% CI 1.01–2.12 and HR 1.13, 95% CI 1.02–1.26, respectively; P for interaction = 0.04). Furthermore, in participants with isovolumetric relaxation time ≤60 ms, mortality risk was higher with increasing uric acid (HR 4.98, 95% CI 2.02–12.26, P for interaction = 0.004). Finally, elevated uric acid predicted ischaemic stroke in subjects with severely enlarged left atria (HR 1.62, 95% CI 1.03–2.53, P for interaction = 0.047). CONCLUSIONS: Increased uric acid was associated with higher all‐cause mortality risk in subjects with echocardiographic indices of diastolic dysfunction, and with higher ischaemic stroke risk in persons with severely enlarged left atria.
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spelling pubmed-53960372017-04-25 Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013 Norvik, Jon V. Schirmer, Henrik Ytrehus, Kirsti Storhaug, Hilde M. Jenssen, Trond G. Eriksen, Bjørn O. Mathiesen, Ellisiv B. Løchen, Maja‐Lisa Wilsgaard, Tom Solbu, Marit D. ESC Heart Fail Original Research Articles AIMS: To investigate whether serum uric acid predicts adverse outcomes in persons with indices of diastolic dysfunction in a general population. METHODS AND RESULTS: We performed a prospective cohort study among 1460 women and 1480 men from 1994 to 2013. Endpoints were all‐cause mortality, incident myocardial infarction, and incident ischaemic stroke. We stratified the analyses by echocardiographic markers of diastolic dysfunction, and uric acid was the independent variable of interest. Hazard ratios (HR) were estimated per 59 μmol/L increase in baseline uric acid. Multivariable adjusted Cox proportional hazards models showed that uric acid predicted all‐cause mortality in subjects with E/A ratio <0.75 (HR 1.12, 95% confidence interval [CI] 1.00–1.25) or E/A ratio >1.5 (HR 1.51, 95% CI 1.09–2.09, P for interaction between E/A ratio category and uric acid = 0.02). Elevated uric acid increased mortality risk in persons with E‐wave deceleration time <140 ms or >220 ms (HR 1.46, 95% CI 1.01–2.12 and HR 1.13, 95% CI 1.02–1.26, respectively; P for interaction = 0.04). Furthermore, in participants with isovolumetric relaxation time ≤60 ms, mortality risk was higher with increasing uric acid (HR 4.98, 95% CI 2.02–12.26, P for interaction = 0.004). Finally, elevated uric acid predicted ischaemic stroke in subjects with severely enlarged left atria (HR 1.62, 95% CI 1.03–2.53, P for interaction = 0.047). CONCLUSIONS: Increased uric acid was associated with higher all‐cause mortality risk in subjects with echocardiographic indices of diastolic dysfunction, and with higher ischaemic stroke risk in persons with severely enlarged left atria. John Wiley and Sons Inc. 2017-01-31 /pmc/articles/PMC5396037/ /pubmed/28451452 http://dx.doi.org/10.1002/ehf2.12134 Text en © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research Articles
Norvik, Jon V.
Schirmer, Henrik
Ytrehus, Kirsti
Storhaug, Hilde M.
Jenssen, Trond G.
Eriksen, Bjørn O.
Mathiesen, Ellisiv B.
Løchen, Maja‐Lisa
Wilsgaard, Tom
Solbu, Marit D.
Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013
title Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013
title_full Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013
title_fullStr Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013
title_full_unstemmed Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013
title_short Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013
title_sort uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the tromsø study 1994–2013
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396037/
https://www.ncbi.nlm.nih.gov/pubmed/28451452
http://dx.doi.org/10.1002/ehf2.12134
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