Prognostic impact of uric acid levels in heart failure with mildly reduced ejection fraction: insights from a large retrospective registry

Background - Elevated uric acid (UA) is a recognized biomarker in patients with cardiovascular disease. However, the prognostic significance of UA levels in patients with heart failure (HF), particularly those with HF with mildly reduced ejection fraction (HFmrEF), remains unexplored. - Methods - Fr...

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Hauptverfasser: Schmitt, Alexander (VerfasserIn) , Behnes, Michael (VerfasserIn) , Bertsch, Thomas (VerfasserIn) , Reinhardt, Marielen (VerfasserIn) , Görtz, Michelle (VerfasserIn) , Abel, Noah (VerfasserIn) , Lau, Felix (VerfasserIn) , Weidner, Kathrin (VerfasserIn) , Dudda, Jonas (VerfasserIn) , Steffen, Henning Johann (VerfasserIn) , Abumayyaleh, Mohammad S. A. (VerfasserIn) , Dürschmied, Daniel (VerfasserIn) , Akın, Ibrahim (VerfasserIn) , Schupp, Tobias (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: October 2025
In: European journal of internal medicine
Year: 2025, Jahrgang: 140, Pages: 1-11
ISSN:1879-0828
DOI:10.1016/j.ejim.2025.06.033
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejim.2025.06.033
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0953620525002717
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Verfasserangaben:Alexander Schmitt, Michael Behnes, Thomas Bertsch, Marielen Reinhardt, Michelle Goertz, Noah Abel, Felix Lau, Kathrin Weidner, Jonas Dudda, Henning Johann Steffen, Mohammad Abumayyaleh, Daniel Duerschmied, Ibrahim Akin, Tobias Schupp

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520 |a Background - Elevated uric acid (UA) is a recognized biomarker in patients with cardiovascular disease. However, the prognostic significance of UA levels in patients with heart failure (HF), particularly those with HF with mildly reduced ejection fraction (HFmrEF), remains unexplored. - Methods - From 2016 to 2022, consecutive patients hospitalized with HFmrEF at one medical centre were retrospectively included. Patients were stratified by pre-specified UA levels (i.e., normal UA: ≥3.5 - ≤6.0 (females) or ≤7.0 (males); low UA: <3.5 and high UA: >6.0 (females) or >7.0 mg/dL (males)), further stratification was performed by UA quintiles. The primary endpoint was all-cause mortality at 30 months (median follow-up), the key secondary endpoint was HF-related rehospitalization. - Results - The study cohort comprised 1419 HFmrEF patients with a median UA of 6.0mg/dL. UA levels above (H) and below (L) the normal range (N) were predictive for the risk of all-cause mortality at 30 months (H: 42% and L: 43% vs. N: 27%), which persisted after multivariable adjustments (H vs N: HR=1.230; 95% CI 1.003-1.508; p = 0.046; L vs N: HR=1.915; 95% CI 1.383-2.650; p = 0.001). Furthermore, there was a trend towards a higher risk of long-term HF-related rehospitalization in patients with elevated UA levels (H: 20% vs. N: 9% vs. L: 8%). However, this finding failed to reach statistical significance after multivariable adjustment (H vs. N: HR=1.408; 95% CI 0.995-1.992; p = 0.053). - Conclusion - Both elevated and low UA levels were associated with an increased risk of long-term all-cause mortality in patients with HFmrEF. 
650 4 |a Heart failure with mildly reduced ejection fraction 
650 4 |a HFmrEF 
650 4 |a Mortality 
650 4 |a Prognosis 
650 4 |a Uric acid 
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