Major adverse cardiovascular events and hyperuricemia during tuberculosis treatment

• Published in: PloS one Vol. 18; no. 11; p. e0294490
• Main Authors: Shin, Hong-Joon, Yoon, Joon-Young, Na, Young-Ok, Lee, Jae-Kyeong, Kho, Bo Gun, Kim, Tae-Ok, Kim, Yu-Il, Lim, Sung-Chul, Jeong, Sae-Hee, Kwon, Yong-Soo
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 16.11.2023; Public Library of Science (PLoS)
• Subjects: Analysis; Anemia; Body mass index; Cardiac arrhythmia; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Chronic obstructive pulmonary disease; Clinical outcomes; Diagnosis; Drug resistance; Drug resistance in microorganisms; Fenofibrate; Health services; Heart; Heart diseases; Hemoglobin; Hospitals; Hypertension; Hyperuricemia; Ischemia; Kidney diseases; Laboratories; Medical research; Medicine, Experimental; Mortality; Multivariate analysis; Patients; Pyrazinamide; Regression analysis; Rheumatism; Risk factors; Tuberculosis; Uric acid; Womens health; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0294490

Hyperuricemia is common during tuberculosis (TB) treatment, especially in association with pyrazinamide (PZA). This study investigated the relationship between major adverse cardiovascular events (MACEs) and hyperuricemia during TB treatment. We conducted a single-center retrospective cohort study. From January 2010 through June 2017, we assessed all consecutive TB patients at Chonnam National University Hospital in South Korea. Hyperuricemia was defined as serum uric acid levels exceeding 7.0 mg/dL (men) and 6.0 mg/dL (women). Of the 1,143 patients included, PZA was administered to 1,081 (94.6%), and hyperuricemia was detected in 941 (82.3%). Eight patients experienced MACEs. Multivariate analysis using logistic regression indicated that prior ischemic heart disease was associated with MACE development (OR,14.087; 95% CI,3.304-60.061; P < 0.000), while hyperuricemia was not (OR, 1.505; 95% CI, 0.184-12.299; P = 0.703). For patients without drug-resistant TB, the absence of hyperuricemia was associated with higher mortality (OR, 2.609; 95% CI, 1.066-6.389; P = 0.036), whereas hyperuricemia was associated with less worse outcomes (OR,0.316; 95% CI,0.173-0.576; P < 0.000). Although most patients treated with PZA developed hyperuricemia, it was not associated with MACE development. Hyperuricemia during TB treatment was associated with better outcomes, possibly due to consistent adherence to TB treatment.