Adding hyperuricemia to traditional cardiac risk factors does not improe ability to predict cardiac or total death in the asymptomatic taiwanese general population

Pai Feng Hsu, Yuan Jen Wang, Yaw Zon Ding, Teh Ling Liou, Ying Wen Wang, Yung Chang Chang, Pesus Chou, Wen Chung Yu, Chen Huan Chen, Wan Leong Chan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Although hyperuricemia is associated with cardioascular disease, such as coronary heart disease (CHD), stroke and hypertension, whether or not including it among traditional risk factors improes the ability to better predict cardiac mortality and total cause of death rates remains controersial. Methods and Results: This was an obserational study based on 57,100 participants without oert cardioascular disease who were enrolled during routine health examinations at Taipei Veterans General Hospital. The participants'mean age was 52.313.4 years. Researchers estimated their serum concentrations of uric acid, and the study used future cardiac and all-cause death as the primary endpoints. During an aerage follow-up period of 5.43.0 years, there were 1,889 deaths, including 231 cardiac deaths among the study subjects. In a multiariable- adjusted analysis with traditional cardioascular risk factors, the hazard ratio of cardiac death associated with hyperuricemia was 1.63 (95% confidence interal [CI]: 1.19-2.22) and 1.60 (95% CI: 0.95-2.71) respectiely, for males and females. The hazard ratio for death from all causes associated with hyperuricemia was 1.12 (95% CI: 1.00-1.26) and 1.41 (95% CI: 1.17-1.70) for males and females, respectiely. The addition of hyperuricemia to the roster of traditional risk factors for cardiac death increased the C statistic from 0.79 (95% CI, 0.76-0.82) to 0.80 (95% CI, 0.77-0.83) for males, and increased it from 0.89 (95% CI, 0.85-0.92) to 0.89 (95% CI, 0.85-0.92) for females; howeer, neither had statistical significance. Furthermore, adding hyperuricemia to known risk factors produced an integrated discrimination improement of 0.009 and-0.0003 respectiely, for males and females, with a 4.11% improement according to net reclassification analysis (p = 0.102), and 0.13% improement according to net reclassification improement (p = 0.484). Conclusion: Our results suggest that hyperuricemia is an independent risk factor for predicting cardiac or all-cause death, although it had borderline significance for females in cardiac death models. Howeer, adding hyperuricemia to traditional cardiac risk prediction models did not significantly improe the ability of the model to predict the risk of cardiac or all-cause death, regardless of whether we used ROC analysis or reclassification methods. Therefore, hyperuricemia per se should not be designated as a treatment target for reducing cardiac or een all-cause death in the general Taiwanese population.

Original languageEnglish
Pages (from-to)225-235
Number of pages11
JournalActa Cardiologica Sinica
Issue number3
StatePublished - Sep 2012


  • Cardioascular risk
  • Hyperuricemia
  • Prediction model


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