Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2024

Open Access 01-12-2024 | Acute Coronary Syndrome | Research

Predictive value of the serum uric acid to high-density lipoprotein cholesterol ratio for culprit plaques in patients with acute coronary syndrome

Authors: Fuxue Deng, Fang Jia, Yang Sun, Lisha Zhang, Jie Han, Danni Li, Qiang Yang, Rongrong Hou, Wei Jiang

Published in: BMC Cardiovascular Disorders | Issue 1/2024

Login to get access

Abstract

Background

Hyperuricemia and low level of high-density lipoprotein cholesterol (HDL-C) are both risk factors for coronary artery disease (CAD). The uric acid to HDL-C ratio (UHR) has recently been identified as a new inflammatory and metabolic biomarker. However, the relationship between the UHR and coronary culprit plaques has not been fully investigated in patients with acute coronary syndrome (ACS).

Methods

A total of 346 patients with ACS were enrolled in this study. Culprit lesion characteristics were assessed by optical coherence tomography (OCT). Logistic regression and linear correlation analyses were performed to assess the association between the UHR and culprit plaques. The predictive value of the UHR was investigated by receiver operating characteristic (ROC) curve analysis.

Results

The percentages of typical culprit plaques, including ruptures, erosions and thrombi, were greater in the high-UHR subgroup than those in the low-UHR subgroup. A positive relationship was also found between the UHR and diameter stenosis (r = 0.160, P = 0.003) and between the UHR and area stenosis (r = 0.145, P = 0.007). The UHR was found to be independently associated with plaque rupture, erosion and thrombus. Furthermore, ROC analysis suggested that the UHR had a better predictive value than low-density lipoprotein cholesterol.

Conclusions

An elevated UHR level was independently related to the occurrence rate of culprit plaques. The UHR is a simple and easily acquired parameter for detecting culprit plaques in patients with ACS.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Lv S, Liu W, Zhou Y, Liu Y, Shi D, Zhao Y, et al. Hyperuricemia and severity of coronary artery disease: an observational study in adults 35 years of age and younger with acute coronary syndrome. Cardiol J. 2019;26(3):275–82.CrossRefPubMedPubMedCentral Lv S, Liu W, Zhou Y, Liu Y, Shi D, Zhao Y, et al. Hyperuricemia and severity of coronary artery disease: an observational study in adults 35 years of age and younger with acute coronary syndrome. Cardiol J. 2019;26(3):275–82.CrossRefPubMedPubMedCentral
3.
go back to reference Tai S, Li X, Zhu Z, Tang L, Yang H, Fu L, et al. Hyperuricemia is a risk factor for one-year overall survival in Elderly Female patients with Acute Coronary Syndrome. Cardiovasc Ther. 2020;2020:2615147.CrossRefPubMedPubMedCentral Tai S, Li X, Zhu Z, Tang L, Yang H, Fu L, et al. Hyperuricemia is a risk factor for one-year overall survival in Elderly Female patients with Acute Coronary Syndrome. Cardiovasc Ther. 2020;2020:2615147.CrossRefPubMedPubMedCentral
4.
go back to reference Mandurino-Mirizzi A, Cornara S, Somaschini A, Demarchi A, Galazzi M, Puccio S, et al. Elevated serum uric acid is associated with a greater inflammatory response and with short- and long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Nutr Metab Cardiovasc Dis. 2021;31(2):608–14.CrossRefPubMed Mandurino-Mirizzi A, Cornara S, Somaschini A, Demarchi A, Galazzi M, Puccio S, et al. Elevated serum uric acid is associated with a greater inflammatory response and with short- and long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Nutr Metab Cardiovasc Dis. 2021;31(2):608–14.CrossRefPubMed
5.
go back to reference Kobayashi N, Hata N, Tsurumi M, Shibata Y, Okazaki H, Shirakabe A, et al. Relation of coronary culprit lesion morphology determined by Optical Coherence Tomography and Cardiac outcomes to serum uric acid levels in patients with Acute Coronary Syndrome. Am J Cardiol. 2018;122(1):17–25.CrossRefPubMed Kobayashi N, Hata N, Tsurumi M, Shibata Y, Okazaki H, Shirakabe A, et al. Relation of coronary culprit lesion morphology determined by Optical Coherence Tomography and Cardiac outcomes to serum uric acid levels in patients with Acute Coronary Syndrome. Am J Cardiol. 2018;122(1):17–25.CrossRefPubMed
6.
go back to reference von Eckardstein A, Nordestgaard BG, Remaley AT, Catapano AL. High-density lipoprotein revisited: biological functions and clinical relevance. Eur Heart J. 2023;44(16):1394–407.CrossRef von Eckardstein A, Nordestgaard BG, Remaley AT, Catapano AL. High-density lipoprotein revisited: biological functions and clinical relevance. Eur Heart J. 2023;44(16):1394–407.CrossRef
7.
go back to reference Julve J, Escola-Gil JC. High-density lipoproteins and Cardiovascular Disease: the Good, the bad, and the future. Int J Mol Sci. 2021;22(14). Julve J, Escola-Gil JC. High-density lipoproteins and Cardiovascular Disease: the Good, the bad, and the future. Int J Mol Sci. 2021;22(14).
8.
go back to reference Park B, Jung DH, Lee YJ. Predictive value of serum uric acid to HDL cholesterol ratio for Incident Ischemic Heart Disease in non-diabetic koreans. Biomedicines. 2022;10(6). Park B, Jung DH, Lee YJ. Predictive value of serum uric acid to HDL cholesterol ratio for Incident Ischemic Heart Disease in non-diabetic koreans. Biomedicines. 2022;10(6).
9.
go back to reference Park B, Jung DH, Lee HS, Lee YJ. Triglyceride to HDL-Cholesterol ratio and the Incident Risk of Ischemic Heart Disease among koreans without diabetes: a Longitudinal Study Using National Health Insurance Data. Front Cardiovasc Med. 2021;8:716698.CrossRefPubMedPubMedCentral Park B, Jung DH, Lee HS, Lee YJ. Triglyceride to HDL-Cholesterol ratio and the Incident Risk of Ischemic Heart Disease among koreans without diabetes: a Longitudinal Study Using National Health Insurance Data. Front Cardiovasc Med. 2021;8:716698.CrossRefPubMedPubMedCentral
10.
go back to reference Tomaniak M, Katagiri Y, Modolo R, de Silva R, Khamis RY, Bourantas CV, et al. Vulnerable plaques and patients: state-of-the-art. Eur Heart J. 2020;41(31):2997–3004.CrossRefPubMedPubMedCentral Tomaniak M, Katagiri Y, Modolo R, de Silva R, Khamis RY, Bourantas CV, et al. Vulnerable plaques and patients: state-of-the-art. Eur Heart J. 2020;41(31):2997–3004.CrossRefPubMedPubMedCentral
11.
go back to reference Deng F, Li D, Lei L, Yang Q, Li Q, Wang H, et al. Association between apolipoprotein B/A1 ratio and coronary plaque vulnerability in patients with atherosclerotic cardiovascular disease: an intravascular optical coherence tomography study. Cardiovasc Diabetol. 2021;20(1):188.CrossRefPubMedPubMedCentral Deng F, Li D, Lei L, Yang Q, Li Q, Wang H, et al. Association between apolipoprotein B/A1 ratio and coronary plaque vulnerability in patients with atherosclerotic cardiovascular disease: an intravascular optical coherence tomography study. Cardiovasc Diabetol. 2021;20(1):188.CrossRefPubMedPubMedCentral
12.
go back to reference Tscharre M, Herman R, Rohla M, Hauser C, Farhan S, Freynhofer MK, et al. Uric acid is associated with long-term adverse cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Atherosclerosis. 2018;270:173–9.CrossRefPubMed Tscharre M, Herman R, Rohla M, Hauser C, Farhan S, Freynhofer MK, et al. Uric acid is associated with long-term adverse cardiovascular outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Atherosclerosis. 2018;270:173–9.CrossRefPubMed
13.
go back to reference Li M, Hu X, Fan Y, Li K, Zhang X, Hou W, et al. Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis. Sci Rep. 2016;6:19520.CrossRefPubMedPubMedCentralADS Li M, Hu X, Fan Y, Li K, Zhang X, Hou W, et al. Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis. Sci Rep. 2016;6:19520.CrossRefPubMedPubMedCentralADS
14.
go back to reference Li W, Wang Y, Ouyang S, Li M, Liu R, Zhang Y, et al. Association between serum uric acid level and carotid atherosclerosis and metabolic syndrome in patients with type 2 diabetes Mellitus. Front Endocrinol (Lausanne). 2022;13:890305.CrossRefPubMed Li W, Wang Y, Ouyang S, Li M, Liu R, Zhang Y, et al. Association between serum uric acid level and carotid atherosclerosis and metabolic syndrome in patients with type 2 diabetes Mellitus. Front Endocrinol (Lausanne). 2022;13:890305.CrossRefPubMed
15.
go back to reference Li Q, Yang Z, Lu B, Wen J, Ye Z, Chen L, et al. Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes. Cardiovasc Diabetol. 2011;10:72.CrossRefPubMedPubMedCentral Li Q, Yang Z, Lu B, Wen J, Ye Z, Chen L, et al. Serum uric acid level and its association with metabolic syndrome and carotid atherosclerosis in patients with type 2 diabetes. Cardiovasc Diabetol. 2011;10:72.CrossRefPubMedPubMedCentral
16.
go back to reference Kim HK, Lee M, Lee YH, Lee BW, Cha BS, Kang ES. Uric acid variability as a predictive marker of newly developed Cardiovascular events in type 2 diabetes. Front Cardiovasc Med. 2021;8:775753.CrossRefPubMedPubMedCentral Kim HK, Lee M, Lee YH, Lee BW, Cha BS, Kang ES. Uric acid variability as a predictive marker of newly developed Cardiovascular events in type 2 diabetes. Front Cardiovasc Med. 2021;8:775753.CrossRefPubMedPubMedCentral
17.
go back to reference Duan Y, Chang X, Ding X, An Y, Wang G, Liu J. Association of hyperuricemia with apolipoprotein AI and atherogenic index of plasma in healthy Chinese people: a cross-sectional study. BMC Cardiovasc Disord. 2022;22(1):372.CrossRefPubMedPubMedCentral Duan Y, Chang X, Ding X, An Y, Wang G, Liu J. Association of hyperuricemia with apolipoprotein AI and atherogenic index of plasma in healthy Chinese people: a cross-sectional study. BMC Cardiovasc Disord. 2022;22(1):372.CrossRefPubMedPubMedCentral
18.
go back to reference He B, Nie Q, Wang F, Wang X, Zhou Y, Wang C, et al. Hyperuricemia promotes the progression of atherosclerosis by activating endothelial cell pyroptosis via the ROS/NLRP3 pathway. J Cell Physiol. 2023;238(8):1808–22.CrossRefPubMed He B, Nie Q, Wang F, Wang X, Zhou Y, Wang C, et al. Hyperuricemia promotes the progression of atherosclerosis by activating endothelial cell pyroptosis via the ROS/NLRP3 pathway. J Cell Physiol. 2023;238(8):1808–22.CrossRefPubMed
19.
go back to reference Lee TS, Lu TM, Chen CH, Guo BC, Hsu CP. Hyperuricemia induces endothelial dysfunction and accelerates atherosclerosis by disturbing the asymmetric dimethylarginine/dimethylarginine dimethylaminotransferase 2 pathway. Redox Biol. 2021;46:102108.CrossRefPubMedPubMedCentral Lee TS, Lu TM, Chen CH, Guo BC, Hsu CP. Hyperuricemia induces endothelial dysfunction and accelerates atherosclerosis by disturbing the asymmetric dimethylarginine/dimethylarginine dimethylaminotransferase 2 pathway. Redox Biol. 2021;46:102108.CrossRefPubMedPubMedCentral
20.
go back to reference Ruggiero C, Cherubini A, Ble A, Bos AJ, Maggio M, Dixit VD, et al. Uric acid and inflammatory markers. Eur Heart J. 2006;27(10):1174–81.CrossRefPubMed Ruggiero C, Cherubini A, Ble A, Bos AJ, Maggio M, Dixit VD, et al. Uric acid and inflammatory markers. Eur Heart J. 2006;27(10):1174–81.CrossRefPubMed
21.
go back to reference Kushiyama A, Nakatsu Y, Matsunaga Y, Yamamotoya T, Mori K, Ueda K, et al. Role of uric acid metabolism-related inflammation in the pathogenesis of metabolic Syndrome Components such as atherosclerosis and Nonalcoholic Steatohepatitis. Mediators Inflamm. 2016;2016:8603164.CrossRefPubMedPubMedCentral Kushiyama A, Nakatsu Y, Matsunaga Y, Yamamotoya T, Mori K, Ueda K, et al. Role of uric acid metabolism-related inflammation in the pathogenesis of metabolic Syndrome Components such as atherosclerosis and Nonalcoholic Steatohepatitis. Mediators Inflamm. 2016;2016:8603164.CrossRefPubMedPubMedCentral
22.
go back to reference Cortese F, Scicchitano P, Cortese AM, Meliota G, Andriani A, Truncellito L, et al. Uric acid in metabolic and cerebrovascular disorders: a review. Curr Vasc Pharmacol. 2020;18(6):610–8.CrossRefPubMed Cortese F, Scicchitano P, Cortese AM, Meliota G, Andriani A, Truncellito L, et al. Uric acid in metabolic and cerebrovascular disorders: a review. Curr Vasc Pharmacol. 2020;18(6):610–8.CrossRefPubMed
23.
go back to reference Hu J, Xi D, Zhao J, Luo T, Liu J, Lu H, et al. High-density lipoprotein and inflammation and its significance to atherosclerosis. Am J Med Sci. 2016;352(4):408–15.CrossRefPubMed Hu J, Xi D, Zhao J, Luo T, Liu J, Lu H, et al. High-density lipoprotein and inflammation and its significance to atherosclerosis. Am J Med Sci. 2016;352(4):408–15.CrossRefPubMed
24.
go back to reference Sorrentino SA, Besler C, Rohrer L, Meyer M, Heinrich K, Bahlmann FH, et al. Endothelial-vasoprotective effects of high-density lipoprotein are impaired in patients with type 2 diabetes mellitus but are improved after extended-release niacin therapy. Circulation. 2010;121(1):110–22.CrossRefPubMed Sorrentino SA, Besler C, Rohrer L, Meyer M, Heinrich K, Bahlmann FH, et al. Endothelial-vasoprotective effects of high-density lipoprotein are impaired in patients with type 2 diabetes mellitus but are improved after extended-release niacin therapy. Circulation. 2010;121(1):110–22.CrossRefPubMed
26.
go back to reference Franczyk B, Rysz J, Lawinski J, Rysz-Gorzynska M, Gluba-Brzozka A. Is High HDL-Cholesterol Level Always Beneficial? Biomedicines. 2021;9(9). Franczyk B, Rysz J, Lawinski J, Rysz-Gorzynska M, Gluba-Brzozka A. Is High HDL-Cholesterol Level Always Beneficial? Biomedicines. 2021;9(9).
27.
go back to reference Aktas G, Kocak MZ, Bilgin S, Atak BM, Duman TT, Kurtkulagi O. Uric acid to HDL cholesterol ratio is a strong predictor of diabetic control in men with type 2 diabetes mellitus. Aging Male. 2020;23(5):1098–102.CrossRefPubMed Aktas G, Kocak MZ, Bilgin S, Atak BM, Duman TT, Kurtkulagi O. Uric acid to HDL cholesterol ratio is a strong predictor of diabetic control in men with type 2 diabetes mellitus. Aging Male. 2020;23(5):1098–102.CrossRefPubMed
28.
go back to reference Hu X, Liu J, Li W, Wang C, Li G, Zhou Y, et al. Elevated serum uric acid was associated with pre-inflammatory state and impacted the role of HDL-C on carotid atherosclerosis. Nutr Metab Cardiovasc Dis. 2022;32(7):1661–9.CrossRefPubMed Hu X, Liu J, Li W, Wang C, Li G, Zhou Y, et al. Elevated serum uric acid was associated with pre-inflammatory state and impacted the role of HDL-C on carotid atherosclerosis. Nutr Metab Cardiovasc Dis. 2022;32(7):1661–9.CrossRefPubMed
29.
go back to reference Yang Y, Zhang J, Jia L, Su J, Ma M, Lin X. The interaction between uric acid and high-density lipoprotein cholesterol on the prognosis of patients with acute myocardial infarction. Front Cardiovasc Med. 2023;10:1226108.CrossRefPubMedPubMedCentral Yang Y, Zhang J, Jia L, Su J, Ma M, Lin X. The interaction between uric acid and high-density lipoprotein cholesterol on the prognosis of patients with acute myocardial infarction. Front Cardiovasc Med. 2023;10:1226108.CrossRefPubMedPubMedCentral
30.
go back to reference Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part I. Circulation. 2003;108(14):1664–72.CrossRefPubMed Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part I. Circulation. 2003;108(14):1664–72.CrossRefPubMed
31.
go back to reference Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part II. Circulation. 2003;108(15):1772–8.CrossRefPubMed Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part II. Circulation. 2003;108(15):1772–8.CrossRefPubMed
Metadata
Title
Predictive value of the serum uric acid to high-density lipoprotein cholesterol ratio for culprit plaques in patients with acute coronary syndrome
Authors
Fuxue Deng
Fang Jia
Yang Sun
Lisha Zhang
Jie Han
Danni Li
Qiang Yang
Rongrong Hou
Wei Jiang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2024
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-024-03824-z

Other articles of this Issue 1/2024

BMC Cardiovascular Disorders 1/2024 Go to the issue