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Clinical Practice Pearls
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
Abstr ct
Cardiology
Uric Acid and Risk of Heart Failure: A Systematic
Review and Meta-analysis
Huang H, et al
Eur J Heart Fail.
2014;16(1):15–24.
The study aimed to perform a systematic review and meta-
analysis to assess the association between serum uric acid
and incident heart failure (HF)/prognosis of HF patients.
A systematic electronic literature search was conducted in
Embase, Medline, and the Chinese Biomedical Literature
Database to identify studies reporting on the association
between serum uric acid and HF. Either a random effects
model or a fixed effects model was used for pooling data.
Five studies reporting on incident HF and 28 studies
reporting on the adverse outcomes of HF patients were
included. The results showed that hyperuricemia was
associated with an increased risk of incident HF and the
risk of all-cause mortality, cardiovascular mortality, and
the composite of death or cardiac events in HF patients.
For every 1 mg/dL increase in serum uric acid, the odds of
development of HF increased by 19%, and the risk of all-
cause mortality and the composite endpoint in HF patients
increased by 4% and 28%, respectively. Subgroup analyses
supported the positive association between serum uric acid
and HF.
Elevated serum uric acid is associated with an increased risk
of incident HF and adverse outcomes in HF patients.
History of Kidney Stones and the Risk of
Coronary Heart Disease
Ferraro PM, et al
JAMA
. 2013;310(4):408–415.
Authors examined the association between a history of
kidney stones and the risk of coronary heart disease (CHD)
in 3 large prospective cohorts.
This is a prospective study of 45,748 men and 196,357
women in the United States without a history of CHD at
baseline, who were participants in the Health Professionals
Follow-up Study (HPFS), Nurses’ Health Study I (NHS
I), and Nurses’ Health Study II (NHS II). The diagnoses
of kidney stones and CHD were updated biennially during
follow up.
CHD was defined as fatal or nonfatal myocardial infarction
(MI) or coronary revascularization. After up to 24 years of
follow up in men and 18 years in women, 16,838 incident
cases of CHD occurred. After adjusting for potential
confounders, among women, those with a reported history
of kidney stones had an increased risk of CHD than those
without a history of kidney stones in NHS I and NHS II.
There was no significant association in men.
Among the 2 cohorts of women, a history of kidney stones
was associated with a modest but statistically significantly
increased risk of CHD; there was no significant association
in a separate cohort of men.
