Lower Uric Acid Blood Level in Anterior Myocardial Infarction Treated by Primary Angioplasty is Associated with Better Coronary Flow and Left Ventricular Systolic Function

Dawod Sharif 1,2 Wisam Abo-Zaid 2 Amal Sharif-Rasslan 3 Uri Rosenschein 1,2
1Cardiology, Bnai Zion Medical Center, Haifa, Israel
2Faculty of Medicine, Technion, Haifa, Israel
3Science and Technology, Technion, Haifa, Israel

Background: Hyperurecemia is related to athersclerotic disease, endothelial dysfunction, slow flow after coronary intervention and recently its prevalence is increasing.

Aim: To test the hypothesis that hyperurecemia on admission is related to coronary flow and left ventricular systolic function after primary percutaneous coronary intervention (PPCI).

Methods: 116 patients with first acute anterior STEMI and treated by PPCI who had results of uric acid (UA) blood levels on admission were evaluated. Coronary artery flow in left anterior descending (LAD) was assessed using the TIMI and myocardial blush grades (MBG). ST-elevation resolution after PPCI was evaluated. Transthoracic Doppler echocardiography was performed early after PPCI and 5 days late to asses left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) of the left ventricle and LAD area. Sampling of LAD blood velocity was performed to measure LAD velocities and integrals, diastolic deceleration times (DDT) and pressure half times (PHT) both early after PPCI and at discharge.

Results: In patients with lowest quartile of UA(<3.4) there were more women 62.5%, all were in Killip calss 1, presented with higher rates (42.3%) of TIMI 3 before PPCI, had more ST-elevation resolution, higher rates of complete ST-elevation resolution (66.6%), and higher rates (50%), of LAD-DDT>600msec early after PPCI, pConclusion: Lower UA blood levels at admission in patients with acute anterior STEMI treated by PPCI present with a higher frequency of TIMI 3 before PPCI, had more ST-elevation resolution, higher prevalence of early LAD-DDT>600msec, and better late left ventricular systolic function as evaluated by LAD-WMSI.









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