SERUM URIC ACID LEVEL IN ACUTE MYOCARDIAL INFARCTION- A POSSIBLE IMPACT ON PROGNOSIS

Dr. Suresh Raghavan* and Dr. Rashmi K. P.

ABSTRACT

Uric acid is the final break down product of the metabolism of the purine. Mean serum uric acid levels of adult males and females are 6.8 and 6.0 mg/dL respectively. Hyperuricemia is defined as serum uric acid levels more than 6.8mg/dL. The role of serum uric acid as an independent risk factor for coronary artery disease remains controversial. Cardiac tissue ischemia and hypoxia deplete adenosine tri phosphate (ATP) and results in the formation of uric acid. This uric acid undergoes rapid efflux into the vascular lumen due to the low intracellular pH. Xanthene oxidase activity and uric acid synthesis are increased in vivo under ischemic conditions. Therefore elevated uric acid may act as a marker of underlying tissue ischemia. Hyperuricemia is associated with deleterious effect on endothelial dysfunction, oxidative metabolism, platelet adhesion hemorrheology and aggregation. Despite these findings, little attention has been paid to the possible relationship between hyperuricemia and Coronary Artery Disease in our population. This study on 100 patients with Acute Myocardial Infarction was undertaken to clarify the apparent association between raised serum uric acid levels and coronary artery disease and the correlation with the Killip class and to find the relationship between uric acid level and mortality. The study concluded that serum uric acid may be a marker of cardiac ischemia and correlated well with the Killip class. Combination of Killip class and serum uric acid after Acute Myocardial Infarction was a good predictor of mortality and helped in predicting the prognosis. However the role of hyperuricemia as an independent risk factor in the development of Coronary Artery Disease could not be established.

Keywords: Hyperuricemia, Uric Acid, Coronary Artery Disease, Acute Myocardial infarction.