Serum uric acid levels are associated with cardiovascular risk score: A post hoc analysis of the EURIKA study

Background Reports are conflicting on whether serum uric acid (sUA) levels are independently associated with increased cardiovascular (CV) death risk. Methods This post hoc analysis assessed the relationship between sUA levels and CV death risk score in 7531 patients from the cross-sectional, multinational EURIKA study (NCT00882336). Patients had at least one CV risk factor but no clinical CV disease. Ten-year risk of CV death was estimated using SCORE-HDL and SCORE algorithms, categorized as low (< 1%), intermediate (1% to < 5%), high (≥ 5% to < 10%) or very high (≥ 10%). Results Mean serum sUA levels increased significantly with increasing CV death risk category in the overall population and in subgroups stratified by diuretics use or renal function (all P < 0.0001). Multivariate ordinal logistic regression analyses, adjusted for factors significantly associated with CV death risk in univariate analyses (study country, body mass index, number of CV risk factors and comorbidities, use of lipid lowering therapies, antihypertensives and antidiabetics), showed a significant association between sUA levels and SCORE-HDL category in the overall population (OR: 1.39 [95% CI: 1.34–1.44]) and all subgroups (using diuretics: 1.32 [1.24–1.40]; not using diuretics: 1.46 [1.39–1.53]; estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m²: 1.30 [1.22–1.38]; eGFR ≥ 60 ml/min/1.73 m²: 1.44 [1.38–1.51]; all P < 0.0001). Similar results were obtained when using SCORE. Conclusions Higher sUA levels are associated with progressively higher 10-year CV death risk score in patients with at least one CV risk factor but no CV disease.