Elevated serum uric acid and risk of cardiovascular or all-cause mortality in people with suspected or definite coronary artery disease: A meta-analysis

Background and aims: Serum uric acid (SUA) has been recognized as an independent risk factor for mortality in the general population. We performed this meta-analysis to determine whether elevated SUA levels are associated with greater risk of cardiovascular or all-cause mortality in people with suspected or definite coronary artery disease (CAD). Methods: The Pubmed and Embase databases were searched up to April 1, 2016 for the longitudinal studies that investigated the association between the elevated SUA and cardiovascular or all-cause mortality risk in people with suspected or definite CAD. Pooled adjusted risk ratio (RR) and corresponding 95% confidence interval (CI) were calculated for the highest vs. the lowest SUA category or each 1 mg/ml SUA rise. Results: Nine studies enrolling 25,229 participants were included in the analyses. The highest vs. lowest SUA category was associated with greater risk of cardiovascular mortality (RR 2.09; 95% CI: 1.45-3.02) and all-cause mortality (RR 1.80; 95% CI: 1.39-2.34) after adjustment for potential confounders in a random effects model. Moreover, each 1 mg/ml SUA rise significantly increased by 12% cardiovascular mortality and by 20% all-cause mortality. Conclusions: Elevated SUA levels are strongly and independently associated with greater risk of cardiovascular and all-cause mortality in people with suspected or definite CAD. (C) 2016 Elsevier Ireland Ltd. All rights reserved.