![]() ![]() 11 We tested whether UA was independently associated with presence and quantity of CAC after adjustment for conventional cardiovascular risk factors. Coronary artery calcification is an established quantitative, objective measure of coronary artery atherosclerosis, and CAC scores have been shown to be related to CHD risk factors 10 and cardiovascular events. ![]() In addition, we sought to investigate the association of UA with the presence and extent of subclinical coronary atherosclerosis, using coronary artery calcification (CAC) as a surrogate. 8 C-reactive protein (CRP) and fibrinogen, markers of systemic inflammation, have been shown to predict CHD events independent of conventional risk factors, and an American Heart Association (AHA) scientific statement has suggested measurement of CRP to be an option in subjects with intermediate 10y-CHDr. The metabolic syndrome is associated with an increased risk of cardiovascular events and the need for its recognition in clinical practice has been emphasized by recent guidelines. Estimating the 10y-CHDr based on the Framingham risk score is the initial step in CHD risk assessment. To better understand the role of UA as a cardiovascular risk marker, we sought to investigate its association with several measures of CHD risk that are currently used in clinical practice, including the estimated 10-year probability of CHD (10y-CHDr), metabolic syndrome, and markers of systemic inflammation. Thus, whether UA is independently associated with CHD remains a subject of debate. 7 On the other hand, the Framingham Heart Study, 5 the Atherosclerosis Risk in Communities (ARIC) study, 6 and Wheeler et al, 4 did not find an independent association of UA with CHD events. 3–6 An independent association of UA with CHD events was observed in the National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study 3 and by Alderman et al. Since then, several studies have attempted to establish whether UA is related to CHD events, independent of the known CHD risk factors. 1 More than 50 years ago, Gertler and co-workers 2 noted an association between elevated levels of serum UA and coronary heart disease (CHD). 1 Serum UA levels, therefore, increase with higher protein intake, increased endogenous production of urate, or decreased excretion of monosodium urate by the kidneys. Uric acid (UA) is the main end product of metabolism of purines, which in turn are derived mostly from diet, de novo biosynthesis, and breakdown of nucleic acids. Uric acid, coronary artery calcium, C-reactive protein, cardiac imaging, metabolic syndrome, atherosclerosis ![]()
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