FRI0228 Urate correlates to coronary artery calcification but not to intima media thickness
Authors: M.I. Dehlin, P. Drivelegka, V. Sigurdardottir, O. Angerås, L.T. Jacobsson, H. Forsblad d’Elia
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Hyperuricemia is closely associated to cardiovascular disease (CVD) although it has not been defintively established whether it is a marker or a causative agent. Serum urate (SU) is strongly linked to the metabolic syndrome, hypertension, hyperlipidemia, kidney failure and higher BMI and higher levels are seen in men compared to women. Coronary artery calcification (CAC) is associated with future risk of atherosclerotic CV events in addition to the traditional cardiovascular risk factors (CVRF). CACs are present in atherosclerotic arteries and can be quantified and scored non-invasively by computed tomography. Carotid intima media thickness (CIMT) is a method of estimating atherosclerosis by assessing the level of arterial thickening present. CIMT can be used as a noninvasive marker of atherosclerotic disease with increasing CIMT linked to an increased risk of subsequent CV events. In the present study we have examined the relation between CACs, CIMT and SU in 1040 male and female with no history of myocardial infarction or stroke. <h3>Objectives</h3> To examine the association bewteen SU and CAC and CIMT respectively in men and women seperately. <h3>Methods</h3> We identified 1106 (552 males) individuals who were screened for traditional CVRFs, such as hypertension (HT), dyslipidemia (DL), diabetes mellitus (DM), smoking, physical activity (PA), educational level (EDU), socioeconomic status (SES), BMI, high sensitive CRP (hsCRP), kidney function by eGFR (eGFR). CACs, reflecting calcification of coronary arteries, was determined according to Agatston<sup>1</sup>. CIMT was calculated as the mean of CIMT of the left and right coronary artery. We measured SU and related quartiles of it to CACs and CIMT with multiple logistic regression analyses adjusting for traditional CVRFs. CAC was defined positive if ≥1. CIMT was defined positive for ≥75 percentile. All study participants with a history of CVD (n=68, 44 male) were excluded. <h3>Results</h3> Of the 1106 participants, 68 were excluded due to history of CVD rendering a study population of 1040 individuals (508 males) with a mean age of 57.7 and 57.5 for male and female respectively. Age, BMI, EDU, SES, smoking status, PA, hsCRP, HT and DL showed no differences between sex while presence of CAC and diabetes was twice as common in men (table 1) and 65% of men displayed an eGFR below 90 mL/min compared to 12% of women (table 1a b). The three upper quartiles of SU (&gt;306 µmol/L) all significantly (p&lt;0.05) predicted presence of CACs in male when adjusting for HT, DL, DM, smoking, PA, EDU, SES, BMI, hsCRP, eGFR and age in multivariate logistic regression, but not in women (table 2). CIMT showed no correlation to SU in men nor women. <h3>Conclusions</h3> Higher levels of SU is associated with presence of CACs in men but not with CIMT. This could suggest that SU is an innocent bystander that covariates with many, but not all, CVRfs. However, it could also imply biological differences in the effect of SU on calcification of coronary arteries compared to carotid intima thickening. Furthermore, SU may exert different effects depending upon biological age and degree of CVD development. <h3>Reference</h3> [1] Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr., Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol1990;15(4):827–832. <h3>Disclosure of Interest</h3> None declared