A study of serum uric acid levels in patients with acute myocardial infarction

Abstract

Purpose: To study the correlation between serum uric acid concentration in patients of acute myocardial infarction.
Material and methods: A study was prospective and observational study. Patient who were admitted in medicine ICU at Krishna institute of medical sciences, Karad. Maharashtra. Patients having acute myocardial infarction (STEMI and/or NSTEMI) were included in this study for a period of 18 months from February 2021 to August 2022. Thus total 100 cases were studied. All data was collected and complied in Microsoft excel. Results of continuous (quantitative data) measurement were presented on Mean +/- SD (min-max) and result on categorical (qualitative data) measurements was presented in percentage and proportions (%).
Results: In this study,the majority 56% of patients were in age group of 50 to 70 years. Mean age was 65.74+ 12.3years, ranging from 37 to 85 years.Out of 100 patients, 76% were males and 24% were females. Male to female ratio was 3:1. Most common clinical presentation was chest pain 66%, followed by sweating 54%, 52% had breathlessness, 23% had backpain and 27% had giddiness.Mean cardiac enzymes were CPK MB 20.5 and Serum Troponin I 4.16.According to Killip’s classification at day 0, majority cases were in group II 50%, and group III 29% only 7% were in group IV. It was also seen that serum uric acid level was increasing as grade increased. According to Killip’s classification at day 3, majority cases were in group II 52%, and group III 31% only 4% were in group IV. According to Killip’s classification at day 5, majority cases were in group II 50%, and group III 34% only 2% were in group IV. In present study of 100 patients 89% (89 patients) were discharged and 11% (11 patients) died.Analysis of the mean levels of serum uric acid levels and Killip’s class revealed positive statistical significance between serum uric acid levels and Killip’s class using student’s T test. Analysis of the mean levels of serum uric acid levels and final outcome of subjects at the end of the study revealed positive statistical significance between serum uric acid levels and final outcome of subjects using student’s T test. Positive statistical correlation between serum uric acid and Troponin I, CPK MB levels was also seen.

Conclusion: The present study was conducted to find relation between serum uric acid sand acute myocardial infarction. As the levels of uric acid increase the severity of disease also increases. It showed that there was a direct relation between serum uric acid levels and myocardial infarction.
Study also showed that patients with higher Killip class had higher levels of serum uric acid in comparison to patients of lower Killip class. Higher levels of serum uric acid level in association with increasing Killip class is a good predictor of the severity and short-term mortality after myocardial infarction. Mortality was seen in class IV followed by class III and class II of Killip’s classification
Thus, patient coming with cardiovascular symptoms and having serum uric acid raised should be taken utmost care so as to avoid further complication related to atherosclerotic cardio vascular diseases. We suggest that serum uric acid can be considered as an additional of investigation which, will be helpful for predicting near future outcome and risk stratification of patients with acute myocardial infarction.