Publication:

Study of serum uric acid levels in patients with acute coronary syndrome and its correlation with clinical features and Killip classification in patients attending tertiary care hospital in Kumaon region of Uttarakhand

Background Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide. Serum uric acid has been suggested as a potential biomarker associated with oxidative stress and cardiovascular risk. This study aimed to evaluate the role of serum uric acid as a prognostic marker in patients with ACS and to assess its association with the Killip classification.

Methods This prospective study was conducted in the Department of Medicine at Government Medical College and Dr. Susheela Tiwari Hospital, Haldwani, from January 2020 to September 2021. A total of 100 patients with confirmed ACS were included based on clinical presentation, ECG changes and elevated cardiac biomarkers. Serum uric acid levels were measured on day 1 and day 3 of admission. Patients were classified according to the Killip classification and clinical outcomes including mortality, complications and duration of hospital stay were recorded.

Results Among the 100 patients, the mean age was 60.97±10.8 years and 63% were males. Hyperuricemia (>8 mg/dl) was observed in 30% of patients on day 1 and 24.49% on day 3. Higher uric acid levels were significantly associated with increased mortality, higher Killip class and greater disease severity (p<0.0001). Patients with hyperuricemia also showed higher prevalence of dyspnoea, hypertension, positive troponin levels, STEMI presentation and cardiovascular complications. Additionally, the duration of hospital stay was significantly longer among patients with elevated uric acid levels.

Conclusions Elevated serum uric acid levels are significantly associated with increased severity, complications and mortality in patients with ACS. Serum uric acid may serve as a simple and useful prognostic biomarker for risk stratification in ACS patients.