on March 20, 2008
Published online before print March 20, 2008, doi: 10.1161/ATVBAHA.107.160184
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Submitted on November 29, 2007
Accepted on March 6, 2008
Uric Acid Levels Are Associated With All-Cause and Cardiovascular Disease Mortality Independent of Systemic Inflammation in Men From the General Population. The MONICA/KORA Cohort Study
Christa Meisinger ;
From the Central Hospital of Augsburg (C.M.), MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany; Helmholtz Zentrum München (C.M., J.B., A.D.), German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany; and the University of Ulm Medical Center (W.K.), Department of Internal Medicine-II, Cardiology, Ulm, Germany.
* To whom correspondence should be addressed. E-mail: wolfgang.koenig{at}uniklinik-ulm.de.
Objective—The purpose of this study was to assess whether increasing serum uric acid (UA) levels are related to cardiovascular disease (CVD) mortality, all-cause mortality, and incident (fatal and nonfatal) myocardial infarction (MI) in men from the general population taking into account C-reactive protein (CRP), a sensitive marker of systemic inflammation.
Methods and Results—The study was based on 3604 men (aged 45 to 74 years) who participated in 1 of the 3 MONICA Augsburg surveys between 1984 and 1995. All participants were prospectively followed within the framework of the Cooperative Health Research in the Region of Augsburg (KORA). Up to December 31, 2002, there occurred 809 total deaths, 359 CVD deaths, and 297 incident MIs. In a Cox model, comparing extreme quartiles of the UA distribution, the hazard ratio for CVD mortality was 1.50 (95% confidence interval [CI] 1.08 to 2.08), and for all-cause mortality it was 1.46 (95% CI 1.18 to 1.81) after adjustment for conventional cardiovascular risk factors, CRP, and diuretic intake. However, UA was not associated with incident MI after multivariable adjustment.
Conclusions—High UA levels were independently associated with CVD mortality as well as all-cause mortality but not with incident MI in middle-aged men from the general population.
Key words: men • mortality • risk factors • serum uric acid • C-reactive protein
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