Uric Acid and Survival in Chronic Heart Failure

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Abstract
Background— Serum uric acid (UA) could be a valid prognostic marker and useful for metabolic, hemodynamic, and functional (MFH) staging in chronic heart failure (CHF). Methods and Results— For the derivation study, 112 patients with CHF (age 59±12 years, peak oxygen consumption [V̇o2] 17±7 mL/kg per minute) were recruited. In separate studies, we validated the prognostic value of UA (n=182) and investigated the relationship between MFH score and the decision to list patients for heart transplantation (n=120). In the derivation study, the best mortality predicting UA cutoff (at 12 months) was 565 μmol/L (9.50 mg/dL) (independently of age, peak V̇o2, left ventricular ejection fraction, diuretic dose, sodium, creatinine, and urea; P<0.0001). In the validation study, UA ≥565 μmol/L predicted mortality (hazard ratio, 7.14; P<0.0001). In 16 patients (from both studies) with UA ≥565 μmol/L, left ventricular ejection fraction ≤25% and peak V̇o2 ≤14 mL/kg per min (MFH score 3), 12-month survival was lowest (31%) c...