Hiperuricemia asintomática y enfermedad arterial coronaria

espanolAntecedentes El acido urico se ha relacionado con la tendencia de precipitarse para formar cristales, que se presenta desde manera asintomatica hasta con artritis, tofos o litiasis renal. Con anterioridad, se ha asociado la hiperuricemia asintomatica a la presencia de enfermedad cardiovascular. Objetivos Determinar la asociacion de enfermedad arterial coronaria compleja en pacientes con hiperuricemia asintomatica. Material y metodos Se realizo estudio observacional, transversal, retrospectivo, unicentrico. En un hospital de tercer nivel de Mexico, en el periodo comprendido de junio del 2017 a marzo del 2019. Se incluyo a todos los pacientes que ingresaron para realizar angiografia coronaria; se excluyo a los pacientes con gota, uso de diureticos y enfermedad renal cronica. Resultados Durante el periodo del estudio se selecciono a un total de 300 pacientes, de los cuales 40% presentaron hiperuricemia. Los pacientes con hiperuricemia eran de mayor edad (59 vs. 63; p = 0,002). El grupo de pacientes con hiperuricemia asintomatica tuvo mayor proporcion de lesiones coronarias complejas (64 vs. 35%; p ≤ 0,0001), asi como tambien mayor puntuacion del SYNTAX I score (27 vs. 17; p ≤ 0,001). Hubo mayor probabilidad de presentar lesiones coronarias complejas en este grupo de pacientes (OR 3,4; p ≤ 0,0001). Ademas, en la division por grupos de nivel de acido urico, se relacionaba con la presencia de lesiones coronarias complejas (Q1 = 0,5; p = 0,06); (Q2 = 2; p = 0,01) y (Q3 = 3; p ≤ 0,0001). Conclusion Los pacientes con hiperuricemia asintomatica tienen mayor riesgo de presentar lesiones coronarias complejas. EnglishBackground Uric acid has been related to a tendency to precipitate to form crystals, presenting asymptomatically, until the formation of arthritis, tophi or renal lithiasis. Previously, the presence of asymptomatic hyperuricaemia has been associated with the presence of cardiovascular disease. Objectives To determine the association of complex coronary artery disease in patients with asymptomatic hyperuricaemia. Material and methods An observational retrospective, transversal, unicentric study was conducted in a tertiary hospital in Mexico, in the period from June 2017 to March 2019. All patients admitted for coronary angiography were included; patients with gout, use of diuretics and chronic kidney disease were excluded. Results During the study period, a total of 300 patients were collected, of which 40% presented hyperuricaemia. The patients with hyperuricaemia were older (59 vs. 63, P = .002). The group of patients with asymptomatic hyperuricaemia had a higher proportion of complex coronary lesions (64 vs. 35%, P ≤ .0001) as well as a higher SYNTAX I score (27 vs. 17, P ≤ .001). There was a higher probability of presenting complex coronary lesions in this group of patients (OR 3.4, P ≤ .0001). In addition, in the group division of uric acid levels, it was related to the presence of complex coronary lesions (Q1 = .5, P = .06), (Q2 = 2, P = .01) and (Q3 = 3, P ≤ .0001). Conclusion Asymptomatic hyperuricaemia has a higher prevalence and association of presenting complex coronary lesions.