Dr Afifa Ashraf, Dr Alia Kanwal
Objective: The aim of this study is to find out an association between the levels or concentration of serum uric acid in the patients present with the suspicion of suffering from CAD (Coronary Artery Disease). Methodology: Study group consisted six hundred and eighty-seven patients with suspicion of coronary artery diseases. All these patients underwent coronary angiography. Stenosis of equal or greater than 50.0% luminal diameter defined coronary artery disease. The expression of the severity of the coronary artery disease was performed as 1-vessel, 2-vessel, or 3-vessel disease. We used the standard of NCEP-ATP 3 (National Cholesterol Education Program-Adult Treatment Panel-3) for MS (Metabolic Syndrome). We obtained the aorto-femoral PWV (Pulse-Wave Velocity) invasively by arterial catheterization. Results: Total three hundred and ninety-five patients were present with coronary artery disease. the level of serum uric acid was high in the patients suffering from coronary artery disease as compared to the patients present without coronary artery disease (5.50 ± 1.00 vs. 5.20 ± 1.00 mg/dL, P= 0.0040). Additionally, there was significant association of serum uric acid with the coronary artery disease severity (P= 0.0020). However, after the adjustment for important confusing factors including DM (Diabetes Mellitus), age, cholesterol level, smoking, metabolic syndrome, PWV and serum uric acid, we found that there was not independent risk factor for incidence of coronary artery diseases (P= 0.1510). On the basis of analysis of sub-group, there was close association of serum uric acid with incidence of coronary artery disease in females as compared to males and in highest quartile ≥ 6.40mg/dL than in initial quartile < 4.80mg/dL; but these results were not much significant (P= 0.0620, P= 0.0750, respectively). According to multivariate regression analysis, Metabolic Syndrome was the most vital determinant of serum uric acid, which has strong association with the incidence of coronary artery disease. Conclusions: In suspected patients of coronary artery disease, serum uric acid was not a risk factor for this complication and it may be simply an indicator of resistance to insulin. KEYWORDS: Coronary Artery Disease, Insulin, Resistance, Serum, Uric, Acid, Metabolic Syndrome.