The Association between Extent and Severity of Acute Coronary Syndrome and Uric Acid, Leukocytes_West China Medical Journal

Authors：

 XIONGXin-lin , TANGJiong , CAILin

Department of Cardiology, No. 3 Hospital of Chengdu/the Second Affiliated Hospital of Chongqing Medical University in Chengdu, Chengdu, Sichuan 610031, P. R. China;

Corresponding author：

Keywords：

Leukocytes; Uric acid; Coronary heart disease; Acute coronary syndrome; Association

DOI：

10.7507/1002-0179.20140552

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Objective To evaluate the association between extent and severity of acute coronary syndrome and uric acid, leukocytes. Methods A retrospective analysis of leukocytes, platelets, lipids and uric acid levels were performed on 23 patients with acute myocardial infarction (AMI group), 17 patients with unstable angina (UA group), and 17 healthy subjects (controls) between January and December 2010. Results In the three groups (AMI, UA, and Control), the leukocyte count was respectively (10.4±3.2)×10⁹/L, (6.9±2.4)×10⁹/L and (5.4±1.1)×10⁹/L (P<0.05); neutrophil was (7.4±3.2)×10⁹/L, (4.8±2.3)×10⁹/L, and (3.4±0.8)×10⁹/L (P<0.001); and uric acid was (401.4±94.3), (384.1±74.1) and (285.5±76.8) μmol/L, respectively (P<0.001). Multinomial Logistic regression showed leukocyte was a predictor for AMI (OR=1.712, P=0.003), while uric acid was not (OR=1.006, P=0.255), regarding the UA group as the reference. When the control group was using as reference, leukocyte was an independently significant factor for AMI (OR=2.942, P=0.004) and was not a significant factor for UA (OR=1.718, P=0.125); uric acid was a significant factor for AMI and UA (OR=1.027, P=0.016; OR=1.021, P=0.041). Conclusion Uric acid may be associated with the chronic development of coronary heart disease, while leukocytes may play a potential role in plaque destabilization and the onset of AMI.

Citation： XIONGXin-lin, TANGJiong, CAILin. The Association between Extent and Severity of Acute Coronary Syndrome and Uric Acid, Leukocytes. West China Medical Journal, 2014, 29(10): 1814-1817. doi: 10.7507/1002-0179.20140552 Copy

1.	Krishnan E, Pandya BJ, Chung L, et al. Hyperuricemia and the risk for subclinical coronary atherosclerosis:data from a prospective observational cohort study[J]. Arthritis Res Ther, 2011, 13(2):R66.
2.	Barron HV, Harr SD, Radford MJ, et al. The association between white blood cell count and acute myocardial infarction mortality in patients >or=65 years of age:findings from the cooperative cardiovascular project[J]. J Am Coll Cardiol, 2001, 38(6):1654-1661.
3.	Thygesen K, Alpert JS, White HD, et al. Universal definition of myocardial infarction[J]. Eur Heart J, 2007, 28(20):2525-2538.
4.	Thygesen K, Alpert JS, Jaffe AS, et al. Third Universal definition of myocardial infarction[J]. Eur Heart J, 2012, 33(20):2551-2567.
5.	葛均波. 急性冠脉综合征[M]//王吉耀. 内科学. 2版. 北京:人民卫生出版社, 2010:294-301.
6.	van der Wal AC, Becker AE, van der Loos CM, et al. Site of intimal rupture or erosion of thrombosed coronary atherosclerotic plaques is characterized by an inflammatory process irrespective of the dominant plaque morphology[J]. Circulation, 1994, 89(1):36-44.
7.	Naruko T, Ueda M, Haze K, et al. Neutrophil infiltration of culprit lesions in acute coronary syndromes[J]. Circulation, 2002, 106(23):2894-2900.
8.	Kojima S, Sakamoto T, Ishihara M, et al. The white blood cell count is an independent predictor of no-reflow and mortality following acute myocardial infarction in the coronary interventional era[J]. Ann Med, 2004, 36(2):153-160.
9.	Ishihara M, Inoue I, Kawagoe T, et al. Impact of prodromal angina pectoris and white blood cell count on outcome of patients with acute myocardial infarction[J]. Int J Cardiol, 2005, 103(2):150-155.
10.	Rohani A, Akbari V, Moradian K, et al. Combining white blood cell count and thrombosis for predicting in-hospital outcomes after acute myocardial infraction[J]. J Emerg Trauma Shock, 2011, 4(3):351-354.
11.	Avramakis G, Papadimitraki E, Papakonstandinou D, et al. Platelets and white blood cell subpopulations among patients with myocardial infarction and unstable angina[J]. Platelets, 2007, 18(1):16-23.
12.	Botto N, Sbrana S, Trianni G, et al. An increased platelet-leukocytes interaction at the culprit site of coronary artery occlusion in acute myocardial infarction:a pathogenic role for "no-reflow" phenomenon?[J]. Int J Cardiol, 2007, 117(1):123-130.
13.	Kim SY, Guevara JP, Kim KM, et al. Hyperuricemia and coronary heart disease:a systematic review and meta-analysis[J]. Arthritis Care Res (Hoboken), 2010, 62(2):170-180.
14.	Coutinho Tde A, Turner ST, Peyser PA, et al. Associations of serum uric acid with markers of inflammation, metabolic syndrome, and subclinical coronary atherosclerosis[J]. Am J Hypertens, 2007, 20(1):83-89.
15.	刘颜梅, 胡大一. 高尿酸血症与高纤维蛋白原血症对冠状动脉风险的联合评估价值探讨[J]. 中华医学杂志, 2006, 86(10):678-680.
16.	Ho WJ, Tsai WP, Yu KH, et al. Association between endothelial dysfunction and hyperuricaemia[J]. Rheumatology, 2010, 49(10):1929-1934.
17.	Kuwahata S, Hamasaki S, Ishida S, et al. Effect of uric acid on coronary microvascular endothelial function in women:association with eGFR and ADMA[J]. J Atheroscler Thromb, 2010, 17(3):259-269.

1. Krishnan E, Pandya BJ, Chung L, et al. Hyperuricemia and the risk for subclinical coronary atherosclerosis:data from a prospective observational cohort study[J]. Arthritis Res Ther, 2011, 13(2):R66.
2. Barron HV, Harr SD, Radford MJ, et al. The association between white blood cell count and acute myocardial infarction mortality in patients >or=65 years of age:findings from the cooperative cardiovascular project[J]. J Am Coll Cardiol, 2001, 38(6):1654-1661.
3. Thygesen K, Alpert JS, White HD, et al. Universal definition of myocardial infarction[J]. Eur Heart J, 2007, 28(20):2525-2538.
4. Thygesen K, Alpert JS, Jaffe AS, et al. Third Universal definition of myocardial infarction[J]. Eur Heart J, 2012, 33(20):2551-2567.
5. 葛均波. 急性冠脉综合征[M]//王吉耀. 内科学. 2版. 北京:人民卫生出版社, 2010:294-301.
6. van der Wal AC, Becker AE, van der Loos CM, et al. Site of intimal rupture or erosion of thrombosed coronary atherosclerotic plaques is characterized by an inflammatory process irrespective of the dominant plaque morphology[J]. Circulation, 1994, 89(1):36-44.
7. Naruko T, Ueda M, Haze K, et al. Neutrophil infiltration of culprit lesions in acute coronary syndromes[J]. Circulation, 2002, 106(23):2894-2900.
8. Kojima S, Sakamoto T, Ishihara M, et al. The white blood cell count is an independent predictor of no-reflow and mortality following acute myocardial infarction in the coronary interventional era[J]. Ann Med, 2004, 36(2):153-160.
9. Ishihara M, Inoue I, Kawagoe T, et al. Impact of prodromal angina pectoris and white blood cell count on outcome of patients with acute myocardial infarction[J]. Int J Cardiol, 2005, 103(2):150-155.
10. Rohani A, Akbari V, Moradian K, et al. Combining white blood cell count and thrombosis for predicting in-hospital outcomes after acute myocardial infraction[J]. J Emerg Trauma Shock, 2011, 4(3):351-354.
11. Avramakis G, Papadimitraki E, Papakonstandinou D, et al. Platelets and white blood cell subpopulations among patients with myocardial infarction and unstable angina[J]. Platelets, 2007, 18(1):16-23.
12. Botto N, Sbrana S, Trianni G, et al. An increased platelet-leukocytes interaction at the culprit site of coronary artery occlusion in acute myocardial infarction:a pathogenic role for "no-reflow" phenomenon?[J]. Int J Cardiol, 2007, 117(1):123-130.
13. Kim SY, Guevara JP, Kim KM, et al. Hyperuricemia and coronary heart disease:a systematic review and meta-analysis[J]. Arthritis Care Res (Hoboken), 2010, 62(2):170-180.
14. Coutinho Tde A, Turner ST, Peyser PA, et al. Associations of serum uric acid with markers of inflammation, metabolic syndrome, and subclinical coronary atherosclerosis[J]. Am J Hypertens, 2007, 20(1):83-89.
15. 刘颜梅, 胡大一. 高尿酸血症与高纤维蛋白原血症对冠状动脉风险的联合评估价值探讨[J]. 中华医学杂志, 2006, 86(10):678-680.
16. Ho WJ, Tsai WP, Yu KH, et al. Association between endothelial dysfunction and hyperuricaemia[J]. Rheumatology, 2010, 49(10):1929-1934.
17. Kuwahata S, Hamasaki S, Ishida S, et al. Effect of uric acid on coronary microvascular endothelial function in women:association with eGFR and ADMA[J]. J Atheroscler Thromb, 2010, 17(3):259-269.

West China Medical Journal

The Association between Extent and Severity of Acute Coronary Syndrome and Uric Acid, Leukocytes

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