مقایسه سطح سرمی اسیداوریک و سایر ریسک فاکتورها در مبتلایان به کاردیومیوپاتی هایپرتروفیک با افراد سالم

نویسندگان

دانشگاه علوم پزشکی بابل

10.22034/NBR.12.4.6
چکیده
مقدمه: کاردیومیوپاتی هایپرتروفیک (HCM) یک بیماری ارثی شایع است که می‌تواند منجر به عوارض حاد قلبی شود. از آنجایی که سطح اسید اوریک به عنوان یک عامل پیش‌بینیکننده بلندمدت برای برخی بیماری‌های قلبی شناخته شده است، این مطالعه با هدف مقایسه سطح اسید اوریک و سایر عوامل خطر بین بیماران مبتلا به HCM و افراد سالم انجام شد.

مواد و روش­ها: این مطالعه مقطعی برروی 100 فرد مراجعه کننده بدرمانگاه متخصص قلب وعروق در دوگروه 50نفری مبتلایان به کاردیومیوپاتی هایپرتروفیک و غیرمبتلا که بمدت یک سال تحت پیگیری قرار گرفتند انجام شد.بیماران از نظر سن، سابقه مصرف الکل، انفارکتوس میوکارد، اندازه گیری سطح اسید اوریک مورد بررسی ومقایسه قرار گرفتند.

نتایج: این مطالعه متغیر­های سن(001/0P<)، شاخص توده بدنی(BMI)(017/0P=)، سابقه مصرف الکل(006/0P=)،مداخله کرونری از راه پوستPCI)) مجدد(022/0P=)، انفارکتوس میوکارد(041/0P=) ومرگ ناشی از بیماریهای قلبی(003/0P=) در بیماران مبتلا به HCM در مقایسه با گروه کنترل بطور معنی داری ارتباط داشتند و از نظر کلی نیز حوادث قلبی عروقی (MACE) نیز بطور معنی داری با گروه کیس مرتبط بودند(001/0P<). این پژوهش بین سطح اسید اوریک با هیچکدام از متغیرها ارتباط معنی داری یافت نشد. دربررسی اثر طولانی مدت متغیرها تنها مصرف سیگار باعث افزایش شانس نزدیک به 27برابری رسیدن به حوادث قلبی عروقی ­شده است.

نتیجه گیری: نتایج مطالعه نشان داد که سن، سابقه مصرف الکل، سابقه انفارکتوس میوکارد از ریسک فاکتورهای مرتبط با بیماری HCM می باشند و سطح اوریک اسید توانایی پیش بینی ابتلا به حوادث قلبی عروقی در طی یک سال در بیماران مبتلا به کاردیومیوپاتی هایپرتروفیک را ندارد.

کلیدواژه‌ها

موضوعات

عنوان مقاله English

Comparison of uric acid serum level and other risk factors in patients with hypertrophic cardiomyopathy with healthy people

نویسندگان English

mohammadtaghi hedayati
mohammadreza zahmatkesh
kamyar amin
hemmat gholinia
چکیده English

Introduction:Hypertrophic cardiomyopathy(HCM)is a common inherited disease that can lead to acute cardiac complications.Since uric acid level is recognized as a long-term predictor for some cardiac diseases,this study aimed to compare serum uric acid levels and other risk factors between patients with HCM and healthy individuals.

Methods:This cross-sectional study was conducted on100individuals referred to a cardiology clinic.Participants were divided into two groups of50:those diagnosed with hypertrophic cardiomyopathy and non-affected individuals,who were followed for one year.Patients were compared based on age, history of alcohol consumption,myocardial infarction,and measured uric acid levels.

Results:The study found that variables such as age(P<0.001), body mass index(BMI)(P=0.017), history of alcohol consumption(P=0.006),repeat percutaneous coronary intervention (PCI)(P=0.022),myocardial infarction(P=0.041),and cardiac-related death(P=0.003)were significantly associated with HCM patients compared to the control group. Overall, major adverse cardiac events(MACE)were also significantly linked to the case group(P<0.001).However,no significant association was found between uric acid levels and any of the variables.In the long-term analysis,smoking was the only factor that increased the risk of cardiovascular events by nearly27-fold.

Conclusion:The results indicated that age, history of alcohol consumption, and prior myocardial infarction are risk factors associated with HCM.Uric acid levels did not prove to be a predictor of cardiovascular events within one year in patients with hypertrophic cardiomyopathy.

کلیدواژه‌ها English

Hypertrophic cardiomyopathy
HCM
Percutaneous coronary intervention
PCI
Uric acid
SUA
Bjornstad, P., et al., 2019. Elevated serum uric acid is associated with greater risk for hypertension and diabetic kidney diseases in obese adolescents with type 2 diabetes: an observational analysis from the treatment options for type 2 diabetes in adolescents and youth (TODAY) study. Diabetes Care. 42(6):1120-8. https://doi.org/10.2337/dc18-2147
Bos, J.M., et al., 2014. Characterization of a phenotype-based genetic test prediction score for unrelated patients with hypertrophic cardiomyopathy. Mayo Clinic Proceedings. 89(6):727-37. https://doi.org/10.1016/j.mayocp.2014.01.025
Cicero, A.F., et al., 2024. Association between serum uric acid, hypertension, vascular stiffness and subclinical atherosclerosis: data from the brisighella heart study. Journal of Hypertension. 32(1):57-64.  https://doi.org/10.1097/HJH.0b013e328365b916
Crouse, J.R., et al., 1987. Risk factors for extracranial carotid artery atherosclerosis. Stroke. 18(6):990-6. https://doi.org/10.1161/01.STR.18.6.990
Fang, J. and M.H. Alderman. 2000. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. 283(18):2404-10. https://doi.org/10.1001/jama.283.18.2404
Forman, J.P., 2009. Uric acid and insulin sensitivity and risk of incident hypertension. Archives of Internal Medicine. 169(2):155-62. https://doi.org/10.1001/archinternmed.2008.521
Freedman, D.S.,  et al., 1995. Relation of serum uric acid to mortality and ischemic heart disease. The NHANES I Epidemiologic Follow-up Study. American Journal of Epidemiology. 141(7):637-44. https://doi.org/10.1093/oxfordjournals.aje.a117479
Fumagalli, C., et al., 2020. Association of obesity with adverse long-term outcomes in hypertrophic cardiomyopathy. JAMA Cardiology. 5(1):65-72. https://doi.org/10.1001/jamacardio.2019.4268
Gao, J., et al. 2021. Uric acid is associated with cardiac death in patients with hypertrophic obstructive cardiomyopathy. Journal of Geriatric Cardiology. 18(4):281-8.  https://doi.org/10.11909/j.issn.1671-5411.2021.04.006
Gertler, M.M., et al. 1951. Serum uric acid in relation to age and physique in health and in coronary heart disease. Annals of Internal Medicine. 34(6):1421-31. https://doi.org/10.7326/0003-4819-34-6-1421
Geske, JB., et al., 2011. Variability of left ventricular outflow tract gradient during cardiac catheterization in patients with hypertrophic cardiomyopathy. JACC Cardiovascular Interventions. 4(6):704-9. https://doi.org/10.1016/j.jcin.2011.02.014
Geske, JB., et al., 2018. Ommen SR, Gersh BJ. Hypertrophic Cardiomyopathy: Clinical Update. JACC Heart Fail. 6(5):364-75. https://doi.org/10.1016/j.jchf.2018.02.010
Hao, Y., et al., 2019. Uricase and horseradish peroxidase hybrid cahpo₄ nanoflower integrated with transcutaneous patches for treatment of hyperuricemia. Journal of Biomedical Nanotechnology. 15(5):951-65. https://doi.org/10.1166/jbn.2019.2752
Huang, H., et al., 2014. Uric acid and risk of heart failure: a systematic review and meta-analysis. European Journal of Heart Failure. 16(1):15-24. https://doi.org/10.1093/eurjhf/hft132
Kannel, WB., et al., 1967. The coronary profile: 12-year follow-up in the Framingham study. Journal of Occupational Medicine. 9(12):611-9. https://www.jstor.org/stable/45000762
Klein, R., et al., 1973. Serum uric acid. its relationship to coronary heart disease risk factors and cardiovascular disease, Evans County, Georgia. Archives of Internal Medicine. 132(3):401-10. https://doi.org/10.1001/archinte.132.3.401
Krishnan, E., et al., 2012. Hyperuricemia and the echocardiographic measures of myocardial dysfunction. Congestive Heart Failure . 18(3):138-43. https://doi.org/10.1111/j.1751-7133.2011.00259.x
Kuwabara, M., et al., 2017. metabolically healthy obesity and hyperuricemia increase risk for hypertension and diabetes: 5-year Japanese cohort study. Obesity (Silver Spring). 25(11):1997-2008. https://doi.org/10.1002/oby.22000
Kuwabara, M., et al., 2018. Elevated serum uric acid increases risks for developing high LDL cholesterol and hypertriglyceridemia: A five-year cohort study in Japan. International Journal of Cardiology. 261:183-8. https://doi.org/10.1016/j.ijcard.2018.03.045
Mohammadi Abgarmi, Z., et al., 2022. Correlation between lipid peroxidation and lipoprotein (a) levels in patients with coronary artery disease. Journal of Genetic Resources. 8(2): 255-263. https://doi.org/10.22080/jgr.2022.23478.1312
Mutluay, R., et al., 2012. Uric acid is an important predictor for hypertensive early atherosclerosis. Advances in Therapy. 29(3):276-86. https://doi.org/10.1007/s12325-012-0006-z
Nabati, M., et al., 2013. Relationship between the level of serum uric acid and severity of coronary artery atherosclerosis determined by coronary angiography in patients with chronic stable angina. Journal of Mazandaran University of Medical Sciences. 22 (98) :19-26 URL: http://jmums.mazums.ac.ir/article-1-1854-en.html
O'Rourke MF., 1992. Frederick Akbar Mahomed. Hypertension. 19(2):212-7. https://doi.org/10.1161/01.HYP.19.2.212
Özyılmaz, S., et al., 2018. Evaluation of the association between serum uric acid level andthe predicted risk score of sudden cardiac death in five years in patients with hypertrophic cardiomyopathy. Archives of the Turkish Society of Cardiology. 46(2):111-20. https://doi.org/10.5543/tkda.2017.60094
Pavlusova, M., et al., 2019. Hyperuricemia treatment in acute heart failure patients does not improve their long-term prognosis: A propensity score matched analysis from the AHEAD registry. Clinical Cardiology. 42(8):720-7. https://doi.org/10.1002/clc.23197
Semsarian, C., et al., 2015. New perspectives on the prevalence of hypertrophic cardiomyopathy. Journal of the American College of Cardiology. 2015;65(12):1249-54. https://doi.org/10.1016/j.jacc.2015.01.019
Singh, JA., et al., 2018. Allopurinol and the risk of incident peripheral arterial disease in the elderly: a US Medicare claims data study. Rheumatology (Oxford). 57(3):451-61. https://doi.org/10.1093/rheumatology/kex232
Siontis, KC., et al., 2014. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. Journal of the American Heart Association. 2014;3(3):e001002. https://doi.org/10.1161/JAHA.114.001002
Suarna, C., et al., 1995. Human atherosclerotic plaque contains both oxidized lipids and relatively large amounts of alpha-tocopherol and ascorbate. Arteriosclerosis, Thrombosis, and Vascular Biology. 15(10):1616-24. https://doi.org/10.1161/01.atv.15.10.1616
Tuttle, KR., et al., 2001. Sex differences in uric acid and risk factors for coronary artery disease. American Journal of Cardiology. 87(12):1411-4. https://doi.org/10.1016/s0002-9149(01)01566-1
Wang, Z., et al., 2020. U-shaped association between serum uric acid concentration and mortality in hypertrophic cardiomyopathy patients. Upsala Journal of Medical Sciences. 125(1):44-51. https://doi.org/10.1080/03009734.2020.1719245
Yoshitomi, R., et al., 2014. Sex differences in the association between serum uric acid levels and cardiac hypertrophy in patients with chronic kidney disease. Hypertension Research. 37(3):246-52. https://doi.org/10.1038/hr.2013.134
Zhu, L., et al., 2015. Plasma uric acid as a prognostic marker in patients with hypertrophic cardiomyopathy. Canadian Journal of Cardiology. 31(10):1252-8. https://doi.org/10.1016/j.cjca.2015.02.018

  • تاریخ دریافت 18 فروردین 1404
  • تاریخ پذیرش 18 مرداد 1404
  • تاریخ انتشار 01 آذر 1404