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TCTAP A-083

Serum Uric Acid as the Low-Cost Examination in the Rural Area for Determine the Severity of Heart Failure: A Meta-Analysis

By Ketut Angga Aditya Putra Pramana, Basuki Rahmat

Presenter

Ketut Angga Aditya Putra Pramana

Authors

Ketut Angga Aditya Putra Pramana1, Basuki Rahmat1

Affiliation

Mataram University, Indonesia1
View Study Report
TCTAP A-083
Others (Unclassified)

Serum Uric Acid as the Low-Cost Examination in the Rural Area for Determine the Severity of Heart Failure: A Meta-Analysis

Ketut Angga Aditya Putra Pramana1, Basuki Rahmat1

Mataram University, Indonesia1

Background

Serumuric acid (UA) levels are a well-known prognostic factor in patients with heartfailure (HF). Increase of xanthine oxidase activity have been shown to beresponsible for elevated serum UA levels in HF. Serum UA levels are a simpleparameters that can be measured anywhere at low cost to predict the severity ofHF.

Methods

Weperformed a systematic search in databases (PubMed, ScienceDirect, and CochraneLibrary). We searched for original research articles that included patientswith heart failure who had undergone for testing the serum UA levels and distinguishedwhich subjects had serum UA >7 mg/dl and serum UA <7 mg/dl. Review Manager 5.4 wasutilized to compute the summary of odds ratios (OR), mean differences (MD), and95% CI for the outcomes. Our outcomes of interest are worsening of symptomsbased on NYHA class III-IV, ejection fraction (EF), and serum NT-proBNP levels.

Results

We identified ten observationalstudies involving 12,479 patients with HF. most of the study subjects had serumUA levels <7 mg/dl (51%) compared serum UA levels >7 mg/dl (49%). Pooled analysis showed that heart failurepatients with serum UA >7 mg/dl significantly had more severe symptoms withNYHA class III-IV [OR 1.57 (95% CI 1.43-1.72; p<0.00001; I2=0%)].The EF of HF patients with serum UA >7 mg/dl was significantly lower by1.99% compared to HF patients with serum UA < 7 mg/dl [MD -1.99 (95% CI -2.29--1.70; p<0.00001; I2=0%)]. When assessed in terms of serumNT-proBNP, HF patients with serum UA > 7 mg/dl had significantly higherserum NT-proBNP levels than HF patients with serum UA < 7 mg/dl [MD 126.22(95% CI 123.82- 128.63; p<0.00001; I2=20%)].


Conclusion

Serumuric acid test can be considered as a simple parameters that can be measuredanywhere especially in rural area at low cost to predict severity of HF. Elevatedserum UA are associated with more severe symptoms, lower EF rates, andincreased serum levels NT-proBNP. Regarding this examination, further researchis needed as a predictor tool of the severity of HF.