AUTHOR=Kim Soohyun , Lee Kwan Yong , Kim Kyung An , Byeon Jaeho , Shin Sanghoon , Hwang Byung-Hee , Kim Jin Jin , Choo Eun Ho , Kim Chan Joon , Kyoung Sa Young , Park Mahn-Won , Hyun Sangho , Yoon Andrew H. , Ahn Youngkeun , Chang Kiyuk 

TITLE=The role of serum uric acid in survival prediction in patients with acute myocardial infarction accompanied by heart failure with preserved ejection fraction

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1622275

DOI=10.3389/fcvm.2025.1622275

ISSN=2297-055X

ABSTRACT=BackgroundHeart failure with preserved ejection fraction (HFpEF) is defined as presenting with clinical symptoms and signs of heart failure with a concomitant left ventricular ejection fraction ≥50%. However, the prognostic role of serum uric acid in HFpEF is not well understood.MethodsIn total, 757 patients with HFpEF and acute myocardial infarction were included in the analysis. Hyperuricemia was defined as a serum uric acid level >6.9 mg/dL in men and >5.4 mg/dL in women at the time of diagnosis of acute myocardial infarction. The primary outcome was all-cause mortality.ResultsAmong the enrolled patients, 164 and 593 were placed into the high uric acid and normal uric acid groups, respectively. After a median follow up of 4.8 years [interquartile range: 3.2–7.1], 54 (32.9%) in the high serum uric acid group and 92 (15.5%) in the normal serum uric acid group had died. Hyperuricemia was independently associated with all-cause mortality (p < 0.001) and cardiovascular death [73 (12.3%) vs. 44 (26.8%); p < 0.001]. The increased risk of mortality remained consistent in the multivariate Cox proportional hazards model (hazard ratio: 1.5; 95% confidence interval: 1.03–2.19; p = 0.033). After classifying the enrolled patients according to their Heart Failure Association-Pre-test assessment, Echocardiography and natriuretic peptide, Functional testing, and Final etiological work-up (HFA-PEFF) score (366 with a HFA-PEFF score <3 and 391 with a HFA-PEFF score ≥3), hyperuricemia was also found to be associated with all-cause mortality in patients with a score greater than the intermediate score (≥3 points) (p < 0.001).ConclusionsIn a cohort with acute myocardial infarction, hyperuricemia was independently associated with all-cause mortality in patients with HFpEF.Clinical Trial RegistrationClinicalTrials.gov, COREA-AMI NCT02806102.