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| Effect of hyperuricemia on the prognosis of acute coronary syndrome patients with intermingled phlegm and blood stasis syndrome after PCI |
| Hits 57 Download times 17 Received:September 09, 2024 |
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| DOI
10.11656/j.issn.1672-1519.2025.01.03 |
| Key Words
acute coronary syndrome;percutaneous coronary intervention;asymptomatic hyperuricemia;propensity score matching;intermingled phlegm and blood stasis syndrome |
| Author Name | Affiliation | E-mail | | ZHANG Hui | Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China | | | XU Qiang | The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, China | tcmxuqiang@hotmail.com | | WANG Baohe | The Fourth Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300451, China
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China | wbh3423@sina.com |
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| Abstract
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| [Objective] Based on real clinical data，this study employs propensity score matching （PSM） to explore the impact of concurrent asymptomatic hyperuricemia （HUA） on the prognosis of intermingled phlegm and blood stasis acute coronary syndrome （ACS） patients undergoing percutaneous coronary intervention（PCI）. This aims to accurately evaluate cardiovascular risks in HUA patients and provides a theoretical foundation for developing integrated treatment strategies that combine traditional Chinese and Western medical practices. [Methods] Data from inpatients aged 45 years or older diagnosed with intermingled phlegm and blood stasis syndrome ACS and undergoing PCI treatment were gathered via the hospital information system from January 2019 to June 2023 in Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine. Follow-ups continued up to 12 months post-PCI. The primary endpoint was major adverse cardiovascular and cerebrovascular events（MACCE），and the secondary endpoint included cardiac death，nonfatal myocardial infarction，stroke and new-onset or aggravated heart failure（HF）. Patients were categorized into HUA and non-HUA groups based on their serum uric acid concentration. Covariates were balanced by 1∶2 PSM，and the effects of HUA on endpoint events were analyzed by multivariate Cox regression. [Results] The study included 484 patients，with an average age of 63.72±10.18. The 74.59% were male and 25.41% were female. The proportion of males was higher in the HUA group compared to the non-HUA group，with a greater prevalence of ST-segment elevation myocardial infarction diagnoses. After PSM，there were 68 （33.66%） patients in the HUA group and 134 （66.34%） in the non-HUA group，with an equitable distribution of covariates. Post-PSM multivariate Cox regression revealed that compared with the non-HUA group，HUA group was associated with a 139% increase in the risk of MACCE[HR=2.39，95%CI（1.13， 5.07），P<0.05] and 272% increase in the risk of new-onset or aggravated HF [HR=3.72，95%CI（1.11，12.48），P<0.05] in 12 months post-PCI. Each 1 μmol/L increase in serum uric acid concentration was associated with a 0.6% increase in both the risk of MACCE [HR=1.006，95%CI（1.002，1.010），P<0.05] and new-onset or aggravated HF [HR=1.006，95%CI（1.000，1.012），P<0.05]. No difference was statistically in the risk of cardiac death，nonfatal myocardial infarction or stroke between two groups（P>0.05）. Subgroup analysis further showed that it was statistically different in the risk of new-onset or aggravated HF between 2 groups in those aged over 65 year，diagnosed with hypertension，diabetes，non-ST-segment elevation acute coronary syndrome and multiple-vessel lesion. [Conclusion] Concurrent asymptomatic HUA at admission is associated with the unfavorable prognosis of PCI in patients aged 45 years or older with intermingled phlegm and blood stasis syndrome ACS，and has potential predictive value for new-onset or aggravated HF. |
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