Correlation between serum uric acid and coronary collateral circulation in patients with coronary chronic total occlusion

Background and purpose: Previous studies showed urate crystals in atherosclerotic plaques, suggesting that uric acid is involved in plaque formation, but whether it affects the formation of coronary collateral circulation (CCC) is unknown. This single-center retrospective study was conducted to investigate whether serum uric acid (SUA) level has an association with the CCC in patients with coronary chronic total occlusion (CTO). Methods: The final analysis included a total of 94 patients with CTO (defined as 100% stenosis in at least one of the left anterior descending artery, circumflex artery and right coronary artery with thrombolysis in myocardial infarction [TIMI] grade 0 of forward flow) for more than 3 months (66.03 ± 10.10 years of age; 54 men and 40 women). In the analysis, patients were divided into four groups of equal size based on the SUA level on admission (n = 32, 31, 31 for low, mid, and high SUA groups). Multivariate logistic regression was conducted to identify risk factors that were associated with poor CCC (as defined by Rentrop level ≤ 1). Results: The rate of poor CCC was 44.5% in the low SUA group, 54.8% in the mid-SUA group, and 77.4% in the high SUA group, respectively (P < 0.05 for all three pairwise comparisons). In multivariate regression analysis that treated SUA as a continuous variable, poorer CCC was associated with higher SUA (adjusted odds ratio [OR] = 1.011, 95% confidence interval [CI]: 1.005–1.017, P < 0.05). In comparison to the patients with lowest SUA in the regression analysis that treated SUA as a categorical variable, there was a statistically non-significant trend for increased risk of poor CCC (OR 2.277, 95% CI: 0.753–6.884) in the patient with mid-level SUA. The risk of poor CCC was significantly elevated in the patients with high SUA (OR 6.243, 95% CI: 1.872–20.828). Conclusions: Elevated SUA level was associated with poor CCC in patients with CTO.