Abstract 16702: BioImage Study: Elevated Uric Acid is Associated Increased Risk of Major Cardiovascular Events Independent of Burden of Subclinical Atherosclerosis and Inflammation

Abstract

Introduction: The role of serum uric acid (UA) as an independent risk factor for cardiovascular disease remains unclear. In this analysis we investigate the association of serum uric acid with the incidence of major adverse cardiac events (MACE) in asymptomatic individuals. Methods: The study population is derived from the prospective BioImage Study designed to evaluate associations among imaging and circulating biomarkers and their ability to predict atherothrombotic events in asymptomatic at-risk subjects aged 55 years and above. MACE was compared by quartiles of serum UA level adjusting for traditional risk factors and subclinical CVD disease markers. Results: The study population consisted of 6,788 individuals (69±6 years, 44% males). The median (IQR) CardioSCORE was 5.3±1.6 mg/dl. Higher UA levels were associated with higher prevalence of obesity, cigarette smoking and hypertension, and higher triglyceride levels. In a median follow-up of 2.5 years, 334 (4.9%) MACE was noted. In age-gender-race analysis one SD increase in UA was associated with 1.30 (1.16-1.45) fold higher risk for MACE. The results remained robust (HR: 1.26, 95% CI: 1.09-1.45) after additional adjustment for risk factors (LDL, HDL, TG, Creatinine, BMI, hypertension, BMI, Diabetes, and FH of premature CHD) as well markers of subclinical CVD (CAC and CRP). Similar associations were noted across increasing UA quartiles (table). Conclusion Hyperuricemia appears to increase the risk of MACE, independently of traditional CHD risk factors and burden of subclinical atherosclerosis and inflammation. Further research is needed to elucidate the mechanistic pathways resulting in increased CVD risk with elevated UA levels.