Uric acid level as a diagnostic and prognostic biomarker of cardiovascular diseases

Abstract

Several studies have suggested an association between hyperuricemia and cardiovascular diseases, resulting in a causal relationship, increased cardiovascular morbidity and improving clinical outcomes by means of pharmacotherapy for reducing uric acid levels. Though still uncertain, most studies suggest that levels of uric acid might be a useful and inexpensive biomarker for diagnosis and / or prognosis. Therefore, this literature review presents the most recent major evidence of uric acid related to cardiovascular diseases such as atherosclerosis, metabolic syndrome, coronary artery disease, heart failure, hypertension, myocardial infarction and mortality from cardiovascular disease. The most controversial data refer to coronary artery disease, possibly because it is a syndrome that includes two conditions - unstable angina and acute myocardial infarction - which makes the analysis low in specificity. Several articles have demonstrated that uric acid, especially hyperuricemia, is a good diagnosis predictor (hypertension and acute myocardial infarction) and prognosis (coronary artery disease and heart failure), however few studies have evaluated the performance of the marker in terms of ROC curve, making it impossible to deliver well-founded conclusions in this regard. Considering the results of most of the evidence, accessibility and low cost of measurements of uric acid levels, we recommend to integrate both the evaluation of hyperuricemia and the analysis of other risk factors.