Title: A Comparative Study of Serum Uric Acid Level in First Degree Relatives of Patients of Acute Coronary Syndrome and In Normal Subjects

Authors: Dr Subha Bhakta, Dr Geeta Baruah, Dr D.J. Dutta

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i3.54

Abstract

Background: Ischaemic heart disease (IHD) is a leading cause of worldwide morbidity and mortality. A number of risk factors have been described in the etiology of IHD. Uric acid is one of the modifiable risk factor plays a role in the development of cardiovascular morbidity in the general population. We can delay the development of IHD by better control of uric acid levels in first degree relatives (FDRs) of IHD patients. We conducted a study in which we  were assess serum uric acid levels independent of other established risk factors in FDRs of IHD patients and in normal subjects.

Method:  Sixty first degree relatives of IHD patients were selected, who were the attendants of the patients coming to the cardiology OPD and patients admitted to Intensive Care Unit (ICU), Assam Medical College Dibrugarh. An equal number of subjects were selected as a control group who had no family history of IHD. After a detailed clinical history and physical examination, fasting blood samples were collected. Blood glucose, lipid profile and serum uric acid levels were estimated.

Results: The serum uric acid levels were found to be significantly high in first degree relatives of acute coronary syndrome in comparison to healthy individuals.

Conclusion:We therefore conclude that high uric acid has a definite role in Cardiovascular disease in first degree relatives.

Key Words: Ischaemic heart disease (IHD), Coronary artery disease (CAD), First Degree Relatives (FDRs), Intensive Care Unit (ICU), serum uric acid (SUA).

References

 1.      Yusuf S, Dunpuu S, Anand S. Global burden of cardiovascular disease. Circulation 2001; 104: 2855-2864.

2.      Anthony S. Fauci, Eugene Braunwald, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, Joseph Loscalzo. Disorders of the cardiovascular system: In: Harrrison’s Textbook of Internal Medicine, Vol-II, 17th Edition, 2008: p: 1365-1576.

3.      Nyyssonen K, Porkkala SE, Salonen JT et al. Ascorbate and urate are the strongest determinants of plasma anti-oxidative capacity and serum lipid resistance to oxidation in Finish men. Atherosclerosis 1997; 130: 223-233.

4.      Ishizaka N, Ishizaka Y, EiIchi T, Nagai R, Yamakado M. Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol. 2005; 25: 1038–1044.

5.      Nieto FJ, Iribarren C, Gross MD, Cosmotock GW, Cutler RG. Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis. 2000; 148: 131–139.

6.      Niskanen LK, Laaksonen DE, Salonen JT et al. Uric acid level as a risk factor for cardiovascular and all cause mortality in middle aged men: a prospective cohort study. Arch Intern Med 2004; 164: 1546-51.

7.      Tyagi SC. Intimal redox stress: accelerated atherosclerosis in metabolic syndrome and type 2 diabetes mellitus. Atheroscleropathy Cardiovas Diabetol 2002; 1: 3. Doi: 10.1186/1475/-2840-1-3.

8.      Hayden MR, Tyagi SC. Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome and type 2 diabetes mellitus. The urate redox shuttle. Nutrition and Metabolism 2004; 1: 10.

9.      Jaffar T, Jafary F, Jessani S. Heart disease epidemic in Pakistan: Females and males are at an equal risk. Am Heart J 2005; 150: 221-226.

10.  Christopher J. Weir, PhD; Scott W. Muir, MBChB, MRCP; Matthew R. Walters, MD, MRCP; Kennedy R. Lees, MD, FRCP. Serum Urate as an Independent Predictor of Poor Outcome and Future Vascular Events After Acute Stroke .Stroke. 2003; 34: 1951-1956.

11.  Wheeler JG, Juzwishin KD, Eiriksdottir G, Gudnason V, Danesh J. Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls : prospective study and meta – analysis. PLOS Med. 2005; 2 (3): e76.

12.  W.S. Waring, D.J. Webb and S.R.J. Maxwell. Uric acid as a risk factor for cardiovascular disease. Q J Med 2000; 93: 707-713. 20.

13.  Liese AD, Hense HW, Lowel H, Doring A, Tietze M. Association of SUA with all – cause and CVD mor-tality and incident MI in the MONICA Augsburg cohort. WHO Monitoring Trends and Determinants in CVD’s. Epidemiology 1999; 10: 391–397.

14.  Bengtsson C, Lapidus L, Stendahl C, Waldenstrom J. Hyperuricaemia and risk of cardiovascular disease and overall death. A 12 – year follow-up of participants in the population study of women in Gothen-burg, Sweden. Acta Med Scand 1988; 224: 549–555.

15.  Jiunn-Horng Chen, Shao-Yuan Chuang, Hsin-Jen Chen, Wen-Ting Yeh, and Wen-Harn Pan,  Serum Uric Acid Level as an Independent Risk Factor for All-Cause, Cardiovascular, and Ischemic Stroke Mortality: A Chinese Cohort Study . Arthritis & Rheumatism (Arthritis Care & Research); 2009, pp 225–232

16.  Bos MJ, Koudstaal PJ, Hofman A, Witteman JC, BretelerMM. Uric acid is a risk factor for myocardial infarction and stroke: the Rotterdam study. Stroke.2006;37(6):1503-1507

17.  Hamidreza Goodarzynejad, MD, Maryam Sotoudeh  Anvari, MD, Mohammad Ali Boroumand, MD, Abbasali Karimi, MD, Seyed Hesameddin Abbasi, MD, Gholamreza Davoodi, MD. Hyperuricemia and the Presence and Severity of Coronary Artery Disease. January 2010; DOI: 10.1309 /LMKDB9PBKZGUS20T, Vol 41 Number 1 , LABMEDICINE 40-44

18.  Milionis HJ, Kalantzi KJ, Goudevenos JA, Seferiadis K,Mikhailidis DP, Elisaf MS. Serum uric acid levels and risk for acute ischaemic non-embolic stroke in elderly subjects. J Intern Med05; 258 (5):435-441.

19.  Tushar B. Patila, c, Amit S. Pasaria, Kiran M. Sargarb, Vinayak E. Shegokara, Yogendra V. Bansoda, Mangesh B. Patila2011 J Neurol Res. Serum Uric Acid Levels in Acute Ischemic Stroke: A Study of 100 Patients • 2011;1(5):193-200.

20.  Bonora E, Targher G,Zeneree MB, Saggiani F, Cacciatori V, Tosi F, Travia D, Zenti MG, Branzi P, Santi L, Muggeo M. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young men Atherosclerosis Risk Factors Study. Int J Obes Relat Metab Disord 1996; 20:975-80.

21.  Nadia Mahmood, Iram Fayyaz and  Robina Basshir) . Comparision of uric acid levels in first degree relatives of ischemic heart disease and normal population. D:/Biomedica Vol.26, Jul. – Dec. 2010/Bio-2.Doc P. 101 – 104

22.  Lp(a), homocysteine and a family history of early ischemic cerebral stroke. Torbus-Lisiecka B, Bukowska H, Jastrzebska M, Chelstowski K, Honczarenko K, Naruszewicz M. Nutr.Metab Cardiovasc dis.  2001 Oct;11 Suppl 5:52-9 .

23.  Pai-Feng Hsu, Shao-Yuan Chuang, Wen-Chung Yu, Hsin-bang Leu, Wan-Leong Chan and Chen-Huan Chen. The Impacts of Serum Uric Acid on arterial hemodynamics and Cardiovascular Risks2013. Acta Cardiol Sin 2013;29:142-150

Corresponding Author

Dr Subha Bhakta

Department of Physiology

Assam Medical College, Dibrugarh, Assam-786002

Email: subha84bThis email address is being protected from spambots. You need JavaScript enabled to view it., Mobile no: 9435678993