Elevated Uric Acid Prevalence and Clinical Outcomes in Patients with Heart Failure with Preserved Ejection Fraction: Insights from RELAX

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Anthony P Carnicelli 1, Jie-Lena Sun 2, Brooke Alhanti 2, Magnus Bjursell 3, Shira Perl 4, Barbara Lytle 2, Matthew T Roe 5, Robert J Mentz 5

Main idea: Serum uric acid is an important marker of comorbidities and functional status in patients with heart failure with preserved ejection fraction. Clinical trials of serum uric acid-lowering therapies in patients with heart failure with preserved ejection fraction are promising.

Abstract

Purpose: We aimed to 1) describe characteristics of patients with heart failure with preserved ejection fraction (HFpEF) enrolled in RELAX stratified by normal or elevated baseline serum uric acid (sUA) level; 2) evaluate the association between sUA level and surrogate clinical measures; and 3) assess associations between changes in sUA level over time and changes in surrogate clinical measures.

Methods: We analyzed 212 patients with HFpEF and normal or elevated sUA measurements from the RELAX trial. Variables examined included clinical characteristics, cardiopulmonary exercise testing, 6-minute walk testing, quality of life, echocardiography, and serum biomarker testing.

Results: The prevalence of elevated baseline sUA was 68.9%. Patients with elevated sUA had more baseline comorbidities and poorer functional status on cardiopulmonary exercise testing than those without. Higher sUA levels were also associated with worsening peak VO2, 6-minute walk testing, and left ventricular mass.

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