Gender differences in the relationship between serum uric acid and the long-term prognosis in heart failure: a nationwide study

Fu, K; Cheng, C; Su, C; Teng, J; Qiao, L; Xiao, J; Ji, X; Lu, H; Chen, W

doi:10.1186/s12933-024-02214-1

Gender differences in the relationship between serum uric acid and the long-term prognosis in heart failure: a nationwide study

Cardiovasc DiabetolPublished 18 Apr 2024Cohort study

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Authors' conclusion

Gender differences in the association between SUA and long-term prognosis of HF existed. SUA was an independent prognostic predictor for long-term outcomes of HF in men, but not in women.

Study context

Population: Heart failure (HF) patients from National Health and Nutrition Examination Survey (NHANES) 1999–2018NHANES 1999–2018
Participants: 1,593 patients

Exposure: Serum uric acid (SUA) and long-term prognosis in men vs women with HF
Menn = 897
Womenn = 696
Outcome: Long-term prognosis: all-cause mortality and cardiovascular mortality
Follow-up: Median 127 months (95% CI 120-134 months)

Methodological detailsnationwide, gender-specific SUA tertiles, Cox proportional hazard model, Fine-Gray competing risk model

Nationwide
Gender-specific SUA tertiles
Cox proportional hazard model
Fine-Gray competing risk model

Main finding

As reported in the abstract

Association of elevated SUA with mortality (multivariate Cox), by gender

Men, all-cause death: HR (95% CI 1.05-1.18), p < 0.001

1.11

Men, cardiovascular death: HR (95% CI 1.09-1.28), p < 0.001

1.18

Women, all-cause death: HR (95% CI 0.98-1.12), p = 0.186

1.05

Women, cardiovascular death: HR (95% CI 0.91-1.12), p = 0.902

1.01

Observational data: associations, not effects.

Further findings

Outcome	Men	Women
Deaths during follow-up · median 127 months
Cardiovascular deaths	206	155

Deaths during follow-up — All-cause deaths, total: 853
Deaths during follow-up — Cardiovascular deaths, total: 361

Kaplan-Meier: SUA tertiles and cardiovascular mortality

Men: Log-rank: P < 0.001
Women: Log-rank: P = 0.150
No gender difference for all-cause mortality

Cardiovascular death with non-cardiovascular death as competing risk (adjusted Fine-Gray)

Men: SHR (95% CI 1.08-1.27), p < 0.001: 1.17
Women: SHR (95% CI 0.87 - 1.10), p = 0.690: 0.98

Original publication

Gender differences in the relationship between serum uric acid and the long-term prognosis in heart failure: a nationwide study. Cardiovasc Diabetol. Published 18 April 2024. doi:10.1186/s12933-024-02214-1

Read the original article ↗

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