Correlations between serum uric acid and coronary atherosclerosis before and during statin therapy.

Objective: The role of serum uric acid (UA) in the pathophysiology of atherosclerosis is ambiguous and remains controversial. The purpose of the present study was to evaluate the relationship between serum UA and coronary atherosclerosis.

Patients And Methods: Coronary atherosclerosis in the nonculprit lesions was evaluated using virtual histology intravascular ultrasound in 119 patients with angina pectoris at the time of percutaneous coronary intervention and 8 months after statin therapy.

Results: Serum UA levels showed weak but significant positive correlations with external elastic membrane volume (baseline: r=0.236, P=0.02; 8-month follow-up: r=0.307, P=0.0009) and with plaque volume (baseline: r=0.263, P=0.007; 8-month follow-up: r=0.349, P=0.0001). Significant decreases in the fibrofatty and fibrous components and increases in the necrotic core and dense calcium components were observed during statin therapy. Serum UA (r=0.257, P=0.009) and unstable angina pectoris (r=0.208, P=0.02) correlated significantly with change in the calcified plaque volume, whereas the estimated glomerular filtration rate trended (r=-0.166, P=0.07). Multivariate regression analyses showed that UA was a significant independent predictor associated with an increase in the dense calcium plaque volume during statin therapy (β=0.244, P=0.03).

Conclusion: In this preliminary study, serum UA levels correlated with coronary atherosclerosis before and during statin therapy. It remains unknown whether these correlations are a direct effect of UA itself or a marker of increased risk.