# Prognostic Significance of Serum Uric Acid and Exercise Capacity in Older Adults Hospitalized for Worsening Cardiovascular Disease

## TL;DR

High serum uric acid levels are linked to worse outcomes in older adults hospitalized for worsening cardiovascular disease, particularly in women.

## Contribution

This study identifies serum uric acid and exercise capacity as potential prognostic markers in older CVD patients, with sex-specific differences.

## Key findings

- Higher serum uric acid levels correlate with worse peak VO2 and higher composite endpoint risk in older CVD patients.
- The highest serum uric acid group had significantly worse outcomes in women but not in men.
- Univariate analysis showed sUA's significance, but multivariate analysis did not confirm this association.

## Abstract

Elevated serum uric acid (sUA) is associated with the risk of developing cardiovascular disease (CVD). Here, we examined the prognostic significance of sUA and exercise capacity in 411 Japanese adults (age, ≥65; mean, 81 years) hospitalized for worsening CVD. When the patients were stratified by sUA into three groups (<5.3, 5.4–6.9, >7.0 mg/dL), the high-sUA group had a significantly worse peak VO2 and composite endpoint (rehospitalization due to worsening CVD and all-cause mortality) compared with low- and moderate-sUA groups (p < 0.001). When the patients were stratified by sUA into five groups (sUA < 3.9, 4.0–5.9, 6.0–7.9, 8.0–8.9, and >10.0 mg/dL), the incidence of the composite endpoint was significantly higher in the highest sUA group compared with that in the reference group, but only in women. Univariate Cox regression analysis, but not a multivariate analysis, indicated that sUA was significantly associated with the composite endpoint. Although sUA and exercise capacity may have some degree of prognostic significance in older patients with CVD, this significance may differ between men and women.