A gender-specific analysis of association between hyperuricaemia and cardiovascular events in patients with coronary artery disease.

Summary Background and aims Gender-related differences in the association between hyperuricaemia and cardiovascular events remain poorly understood. The objective of this study was to assess gender-related differences in the association between hyperuricaemia and cardiovascular events in patients with coronary artery disease (CAD). Methods and results This study included 13,273 patients with CAD. Hyperuricaemia was defined as a plasma uric acid >7.0mgdl −1 in men and >5.7mgdl −1 in women. The primary outcome was 1-year all-cause mortality. Hyperuricaemia was found in 3745 men (36.5%) and 1562 women (50.3%); odds ratio (OR)=1.76, 95% confidence interval (CI) 1.62–1.91; P n =143) in women with hyperuricaemia versus 6.9% (n = 252) in men with hyperuricaemia ( P =0.002). After adjustment in multivariable Cox proportional hazards model, uric acid predicted 1-year mortality with an adjusted hazard ratio (HR)=1.17, 95% CI (1.03–1.31), P =0.012 in men and HR=1.25, 95% CI (1.06–1.48), P =0.007 in women, for each standard deviation increase in the natural logarithm. Uric acid predicted 1-year mortality with an area under the receiver-operating characteristic curve=0.625, 95% CI (0.594–0.656) in men and 0.676, 95% CI (0.635–0.717) in women ( P =0.044, for women versus men). Conclusion Hyperuricaemia predicts an increased risk of 1-year mortality in both genders with a stronger association in women. Differences in cardiovascular risk profile may explain the stronger association between hyperuricaemia and cardiovascular events in women.