The correlation of elevated uric acid to cardiovascular outcomes of admitted acute coronary syndrome patients from 2018 to 2022: a single-center, cross-sectional retrospective study

Abstract Background Hyperuricemia, defined as elevated serum uric acid (SUA), has emerged as a significant risk factor for cardiovascular diseases, particularly in patients with acute coronary syndrome (ACS). Although SUA is widely recognized for its role in gout and renal dysfunction, its potential as a predictive marker for cardiovascular events remains underexplored. Given its association with oxidative stress, endothelial dysfunction, and inflammation—key contributors to atherogenesis—this study aims to assess the relationship between elevated SUA levels and clinical outcomes in ACS patients in a local setting, including mortality and major adverse cardiovascular events (MACE). Methods This retrospective, cross-sectional study analyzed data from 219 patients admitted with ACS (STEMI or NSTEMI) between January 2018 and December 2022. Inclusion criteria required a confirmed diagnosis of ACS, with SUA levels measured during hospitalization. Hyperuricemia was defined as SUA ≥ 6.8 mg/dL. The primary outcomes were in-patient mortality and MACE (including reinfarction, cardiogenic shock, and varying degrees of heart failure). Descriptive statistics were used to summarize demographic and clinical characteristics. Pearson chi-square and independent t-tests assessed differences in outcomes, while Pearson correlation determined the relationship between SUA levels and cardiovascular outcomes. A significance level of p 0.05 was used for all analyses. Results The mean age of the patient cohort was 68.1 years, with a nearly balanced gender distribution (53% male, 47% female). The study found that 62% of ACS patients had hyperuricemia, with a mean SUA of 9.48 mg/dL. Significant associations were observed between elevated SUA levels and poorer clinical outcomes. Patients with hyperuricemia had longer hospital stays (9.48 vs. 8.79 days), higher mortality (18% vs. 10%), and greater rates of reinfarction (9% vs. 5%) compared to those with normal uric acid levels. In addition, hyperuricemic patients had more severe heart failure, with 31.3% experiencing mild heart failure (Killip Class II) and 12.8% presenting with severe heart failure (Killip Class III), compared to 16.4% and 5.9%, respectively, in those with normal SUA. Furthermore, hyperuricemia was associated with a higher incidence of cardiogenic shock (11.4% vs. 8.2%). All differences were statistically significant (p 0.05). Conclusions This study demonstrates that elevated uric acid levels are independently associated with worse clinical outcomes in patients with acute coronary syndrome, including increased mortality, higher reinfarction rates, more severe heart failure, and prolonged hospital stays. The findings suggest that SUA could serve as a useful prognostic marker in ACS, offering potential value in risk stratification and patient management.