Higher serum urate levels are associated with an increased risk for sudden cardiac death
Abstract
Objective Determine the association of serum urate levels with sudden cardiac death and incident coronary heart disease (CHD), separately, among adults without a history of CHD.
Methods We conducted a case-cohort analysis of Black and White participants ≥45 years of age enrolled in the REason for Geographic And Racial Differences in Stroke (REGARDS) study without a history of CHD at baseline between 2003 and 2007. Participants were followed for sudden cardiac death or incident CHD (i.e., myocardial infarction or death from CHD excluding sudden cardiac death) through December 31, 2013. Baseline serum urate was measured in a random sample of participants (n=840) and among participants who experienced sudden cardiac death (n=235) or incident CHD (n=851) during follow-up.
Results Participants with higher serum urate levels were older and more likely to be male or Black. The crude hazard ratio (95%CI) per 1 mg/dL higher serum urate level was 1.26 (1.14-1.40) for sudden cardiac death and 1.17 (1.09-1.26) for incident CHD. After adjustment for age, gender, race, and cardiovascular risk factors, the hazard ratio (95%CI) per 1 mg/dL higher serum urate level was 1.19 (1.03-1.37) for sudden cardiac death and 1.05 (0.96-1.15) for incident CHD. Hazard ratios for sudden cardiac death were numerically higher among participants 45-64 versus ≥65 years of age, without versus with diabetes, and among those of White versus Black race, although p-values for effect modification were all ≥0.05.
Conclusion Higher serum urate levels were associated with an increased risk for sudden cardiac death but not with incident CHD.