| Objective:To explore the linkage between baseline serum uric acid,cardiac function and prognosis in patients with coronary heart disease.Methods:From January 2015 to June 2015,totally 816 patients with coronary heart disease(including revascularization)verified by coronary angiography during hospitalization in our hospital were retrospectively selected and 166 patients with negative results of coronary angiography were concluded as the control group.General clinical data(gender,age,TC,LDL,FBG,SCR,SUA)and other laboratory indicators and past medical history records such as HBP,DM,Smoking and LVEF were collected.The SPSS 21 software was chosen for statistical analysis.Measurement data such as continuous variables were expressed as mean ± standard deviation((?)±s)and counting data was presented as number of cases(referring to percentage).The independent sample t test was used to compare the measurement data in line with normal distribution between the CHD patients group and the control group,the death group for CHD and in-hospital CHD patients group.otherwise the rank sum test was chosen.Chi-square test was selected for counting data to compare the statistical differences between the above two groups and to see whether there was a statistical difference in serum uric acid(SUA)between the two groups.Based on the ESC guidelines for acute and chronic heart failure in 2016,CHD patients’ LVEF were divided into three groups: HFr EF(EF≤40%),HFmr EF(40% < EF < 50%)and HFp EF(EF≥50%).One-way analysis of variance was used to compare the serum uric acid levels between the three groups.According to the American Heart of Association coronary segment classification,organic cardiac disease was defined as the degree of stenosis of major coronary arterise(referring to the left anterior descending(LAD),left circumflex(LCX)and right coronary artery)≥75% verified by coronary angiography.Based on the number of diseased vessels with significant organic lesions,the patients were divided into three groups respectively 1,2 and 3.In addition,the covariance path model which IBM SPSS AMOS statistical software was used for statistical analysis analyzed the correlationship among SUA,coronary artery lesions severity and left ventricular ejection fraction by controlling other confounding factors.Finally 635 CHD patients were followed up for 610 days.Cox regression analysis was used to analyze the factors that affected hyperuricemia in CHD patients with heart failure.According to the SUA level who completed follow-up,the patients were divided into two groups,the hyperuricemia and the normal uric acid group respectively.Chi-square analysis was used for comparing the probability of cardiovascular events between the two groups.Results:1.The comparative analysis of general clinical data and medical records between the two groups were statistically significant differences in gender,age,SUA,SCR,LVEF and previous history of diabetes between the two groups(P < 0.05)..Among them,age,SUA,SCR and LVEF in the CHD group all went higher than those in non-CHD group,while LVEF level was much lower than that in the non-CHD group;Man counted mostly in the CHD group.Greater statistical differences were manifestated in gender,SCR,SUA,blood glucose and LVEF between the automatic discharge(the death)group and the CHD group(P < 0.05).2.Pair comparison of SUA among three groups with different LVEF showed that LVEF in the CHD group was much lower than that in the non-CHD group,and there was a negative relationship between LVEF and blood uric acid level(P < 0.05).3.The analysis of covariance pathway model showed that high uric acid was a risk factor for the progression of coronary artery disease,and the more severe the coronary artery disease,the lower the LVEF.More importantly,hyperuricemia was an important independent influencing factor for LVEF.4.After follow-up,a total of 635 patients with CHD finished followed-up,and no cardiovascular death occurred.The average follow-up time was 610 days.According to Cox regression analysis,LVEF and SCR were independent influencing factors for hyperuricemia in CHD patients(95% confidence intervals(1.001-1.015)P =0.022;95%confidence intervals(0.961-0.992)P =0.003).5.According to the chi-square test,the probability of heart failure events in CHD patients in the hyperuricemia group was higher than that in the normal group,and there was a significant statistical difference between the two groups(P < 0.05).Conclusion:In this study,it was found that the SUA level of CHD patients seemed higher than that of the normal population group,and LVEF level seemed much lower than that of the commom population group.The lower the LVEF of CHD patients,the higher SUA,and the two presented a negative relationship.In addition,high uric acid was an independent risk factor directly causing coronary artery disease,which eventually lead to left ventricular ejection dysfunction.LVEF and Scr were independent influencing factors for predicting the occurrence of serum uric acid in patients with CHD,and last hyperuricemia was likely to increase the ocurrence rate of heart failure and death in patients with CHD. |
