The following 2 abstracts were omitted from the Abstracts From the 72nd Scientific Sessions, Atlanta, Georgia, November 7–10, 1999 (Circulation. 1999;100[Suppl I]).
Uric Acid and Mortality Risk Among Elderly Patients With Congestive Heart Failure: A 7-Year Prospective Study
Abraham A. Ariyo, University of California, Davis, Sacramento; Richard Kronmal, University of Washington, Seattle; William R. Lewis, John Robbin, University of California, Davis, Sacramento; Gregory Burke, Wake Forest University, Winston-Salem, NC
Background: Several investigators have reported a positive association between hyperuricemia and poor outcome among patients with congestive heart failure (CHF). We investigated the relationship between elevated uric acid (UA) levels and mortality among elderly patients with CHF. Methods: Of the 5201 elderly participants enrolled in the Cardiovascular Health Study, 256 were diagnosed with CHF at study entry, provided blood samples for UA level determination, and were followed prospectively for an average of 7 years. Results: Using Cox-proportional hazards models, we assessed the mortality hazards associated with each quintile level of UA using the first quintile as the reference group. The overall mortality was high. Mortality versus UA quintiles is shown below. These results remained nonsignificant in multivariate analyses adjusted for age, diuretic use, ejection fraction, renal dysfunction, and other clinical parameters associated with poor prognosis in CHF patients. Conclusions: We found that elevated serum uric acid was not associated with increased risk of death among elderly patients with CHF. This data does not support the use of UA level measurement as a marker of poor prognosis in this population.⇓
Lipoprotein(a) and Risk of Stroke Among Elderly Subjects: A 6-Year Prospective Study
Abraham A. Ariyo; Daniel O’Leary; Russell Tracy; Chau Thach; Jan Busby-Whitehead; Peter Savage; David Siscovick, University of California, Davis, Sacramento
Background: Lipoprotein(a) [Lp(a)] has been shown to play a vital role in atherogenesis and pathologic thrombus formation. Although several investigators have reported a positive association between Lp(a) and stroke in the middle-aged, data on this relationship among the elderly (>65 years) are sparse. Method: In a prospective study of the 5201 elderly subjects enrolled in the Cardiovascular Health Study, 1578 men and 2378 women who were free of cardiovascular disease at study entry, provided baseline plasma samples for Lp(a) determination were followed for an average of 6 years for the development of stroke. Results: Using Cox-proportional hazard models, among men, the hazard ratios associated with each quintile level of Lp(a) on future development of stroke, using the first quintile as the reference group, were 2.2 (1.1–4.3), 2.4 (1.2–4.7), 2.3 (1.1–4.5), and 2.8 (1.4–5.5); P=0.03. In multivariate analyses adjusted for age, total cholesterol, low-density lipoprotein cholesterol, diabetes, mean systolic and mean diastolic hypertension, and cigarette smoking the hazard ratios associated with each quintile level of Lp(a) on future development of stroke were 2.2 (1.0–4.1), 2.3 (1.2–4.6), 2.3 (1.1–4.5), and 2.7 (1.3–5.4); P=0.04. The results of analyses among women were nonsignificant. Conclusion: In this large prospective study of the elderly, elevated level of Lp(a) was an independent risk factor for future development of stroke among elderly men but not in women. This data supports the concept of sex-specific atherogenicity of Lp(a) in this population.
- Copyright © 2000 by American Heart Association