What is the cutoff value of serum uric acid for predicting heart failure?

Serum uric acid (SUA) has been shown to be an independent predictor of the risk for all heart failure (HF) and fatal HF, after adjusting for potential confounding variables, a study has shown. In addition, a prognostic cutoff value has been identified for all and fatal HF.

This nationwide, multicentre, cohort study recruited 21,386 individuals from all regions of Italy under the patronage of the Italian Society of Hypertension, with a mean follow-up of 128 months. Incident heart failure was defined according to the International Classification of Diseases Tenth Revision codes and double-checked with general practitioners and hospital files.

Multivariable Cox regression models, adjusted for potential confounders, were used to examine the association between SUA as a continuous variable and HF. Receiver operating characteristic (ROC) curves were used to identify two prognostic cutoff values, one for all and one for fatal HF, to discriminate between individuals who were inclined to develop the event.

Cox analysis revealed that SUA as a continuous variable significantly predicted all (hazard ratio [HR], 1.29, 95 percent confidence interval [CI], 1.23–1.359; p<0.0001) and fatal (HR, 1.268, 95 percent CI, 1.121–1.35; p<0.0001) incident HF.

Cutoff values of SUA were identified by mean of ROC curves in the whole database. The prognostic cutoff value for all HF was SUA >5.34 mg/dl (95 percent CI, 4.37–5.6; sensitivity, 52.32; specificity, 63.96; p<0.0001), and for fatal HF SUA >4.89 mg/dl (95 percent CI, 4.78–5.78; sensitivity, 68.29; specificity, 49.11; p<0.0001).

In Cox analysis models, the cutoff values for all and fatal HF were accepted as independent predictors (all HF: HR, 1.645, 95 percent CI, 1.284–2.109; p<0.0001; fatal HF: HR, 1.645, 95 percent CI, 1.284–2.109; p<0.0001).