Higher Serum Urate Levels Are Associated With an Increased Risk for Sudden Cardiac Death.
OBJECTIVE
To determine the association of serum urate (SU) 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 aged ≥ 45 years 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 [MI] or death from CHD excluding sudden cardiac death) through December 31, 2013. Baseline SU 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 SU levels were older and more likely to be male or Black. The crude HR (95% CI) per 1 mg/dL higher SU 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, sex, race, and cardiovascular risk factors, the HR (95% CI) per 1 mg/dL higher SU level was 1.19 (1.03-1.37) for sudden cardiac death and 1.05 (0.96-1.15) for incident CHD. HRs for sudden cardiac death were numerically higher among participants aged 45-64 vs ≥ 65 years, without vs with diabetes, and among those of White vs Black race, although P values for effect modification were all ≥ 0.05.


CONCLUSION
Higher SU levels were associated with an increased risk for sudden cardiac death but not with incident CHD.
['Colantonio|Lisandro D|LD|0000-0001-8742-1788', 'Reynolds|Richard J|RJ|', 'Merriman|Tony R|TR|0000-0003-0844-8726', 'Gaffo|Angelo|A|0000-0001-7365-7212', 'Singh|Jasvinder A|JA|0000-0003-3485-0006', 'Plante|Timothy B|TB|0000-0001-9992-9597', 'Chaudhary|Ninad S|NS|', 'Armstrong|Nicole D|ND|0000-0002-6483-4560', 'Soliman|Elsayed Z|EZ|', 'Curtis|Jeffrey R|JR|0000-0002-8907-8976', 'Bridges|S Louis|SL|', 'Lang|Leslie|L|', 'Howard|George|G|0000-0002-3068-5720', 'Safford|Monika M|MM|', 'Saag|Kenneth G|KG|', 'Muntner|Paul|P|', 'Irvin|Marguerite Ryan|MR|0000-0002-1442-2023']
D000328:Adult D001741:African Americans D003327:Coronary Disease D016757:Death, Sudden, Cardiac D005260:Female D006801:Humans D015994:Incidence D008297:Male D012307:Risk Factors D014527:Uric Acid
sudden cardiac death coronary heart disease adults primary prevention uric acid