Title: Association between Serum Uric Acid Level and Coronary Artery Disease

Background/Purpose: Previous studies have shown an unclear relationship between serum uric acid (SUA) and coronary artery disease (CAD). We attempt to clarify this relationship using the largest public US dataset available; the National Health and Nutrition Examination Survey (NHANES).

Methods: NHANES data from 2003 to 2014 was selected based on an affirmative response to the questions: 1. “Ever told you had angina/angina pectoris”, 2. “Ever told you had heart attack”, and 3. “Ever told you had coronary heart disease”. The resulting data set was analyzed for uric acid levels (cut-off >6.0 mg/dL in females and >7.0 mg/dL in males), and CAD risk factors. Proportional analyses as well as univariate and multiple logistic regression models were used to evaluate the associations between SUA levels and CAD.

Results: 36,267 survey participants (Mean age 49.35 yrs.) from 2003 to 2014 were included in the study. There were 20,201(51.7%) females and 18863 (48.3%) males. A total of 2797 (7.2%) had CAD; 39% of these were female and 61% were male. Univariate analyses showed a significant association between high SUA levels (OR 1.4; 95% CI 1.3 – 1.6), hypertension (OR 1.1; 95% CI 1 – 1.2), and renal dysfunction (OR 2.0; 95% CI 1.8 – 2.3). The relationship between SUA and CAD was reaffirmed in our multiple regression models (p-value <0.001) after adjusting for age, sex, race, smoking, diabetes, blood pressure and cholesterol.

Conclusion: Our study showed that there is a significant association between SUA levels and CAD in the NHANES population. This suggests that including SUA in risk models may improve risk stratification for CAD. Further prospective studies are needed to confirm this association and clarify the mechanisms behind it.