Background/Purpose: While the relationship between serum uric acid (SUA) and coronary artery disease (CAD) remains controversial, emerging evidence suggests a particularly significant association in patients lacking traditional cardiovascular risk factors. The specific role of hyperuricemia in determining CAD severity in non-hypertensive, non-diabetic populations warrants further investigation.

Methods: In this retrospective cohort study, we analyzed 716 consecutive CAD patients undergoing percutaneous coronary intervention (PCI), with a focus on 279 individuals without hypertension or diabetes. We employed multivariable logistic regression and stratified analyses to assess the independent association between SUA levels and multiple stent implantation (≥2 stents), a robust indicator of CAD complexity and prognosis. Hyperuricemia was defined using gender-specific thresholds ( >420 μmol/L for males and postmenopausal females; >360 μmol/L for premenopausal females).

Results: In the overall cohort, multivessel disease (OR=2.27, 95% CI:1.94–3.96, p < 0.001) and diabetes (OR=1.47, 95% CI:1.05–2.07, p=0.027) independently predicted multiple stent placement. Notably, in the non-hypertensive, non-diabetic subgroup, hyperuricemia emerged as a strong independent predictor (OR=4.62, 95% CI:1.93–11.07, p=0.001), exceeding the predictive value of multivessel disease (OR=3.16, 95% CI:1.78–5.55, p < 0.001). No significant association was observed between SUA levels and stent number in the broader cohort.

Conclusion: Elevated serum uric acid independently predicts complex coronary lesions requiring multiple stent placements in non-hypertensive, non-diabetic CAD patients. These findings suggest that uric acid assessment may enhance risk stratification in this specific patient population, warranting further investigation into its clinical implications.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/elevated-serum-uric-acid-as-an-independent-risk-factor-for-multiple-stent-placement-in-non-hypertensive-non-diabetic-patients-with-coronary-artery-disease-a-retrospective-cohort-analysis/