, Gediz Doğay Us 2
, Eray Aksoy 3
, Şahhan Kılıç 4
, Gülsüm Bingöl 5
, Leyla Bulut 6
, Haşim Tüner 7
, Elif Ayduk Gövdeli 8
, Ümit Acar 9
, Batool Achmar 10
, Barış Ökçün 9
, Melih Us 11
2Department of Cardiovascular Disease, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; Department of Cardiovascular Disease, Pax Clinic, İstanbul, Türkiye
3Department of Cardiovascular Surgery, Vehbi Koç Foundation American Hospital, İstanbul, Türkiye
4Department of Cardiology, Ministry of Health Çorlu State Hospital, Çorlu, Türkiye
5Department of Cardiology, Faculty of Medicine, Arel University, İstanbul, Türkiye
6Department of Biochemistry, Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
7Department of Cardiology, İstanbul Arel University, Memorial Bahçelievler Hospital, İstanbul, Türkiye
8Department of Cardiology, Royal Brompton Hospital, Chelsea, London, United Kingdom
9Department of Cardiology, İstanbul Üniversitesi – Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
10Bahçeşehir University Faculty of Medicine, İstanbul, Türkiye
11Department of Cardiovascular Disease, Pax Clinic, İstanbul, Türkiye
Abstract
Objective: A recently proposed uric acid index combining fasting glucose, triglycerides, and uric acid has shown promise in cardiovascular risk stratification. It was assessed whether the index could predict significant coronary artery stenosis (≥50%) on coronary computed tomography (CT) angiography and compared its diagnostic performance with
serum uric acid.
Methods: In this retrospective, single-center study, 258 adults who underwent coronary CT angiography between January 2023 and December 2024 were included. Coronary calcification was scored using the Agatston method by 2 cardiologists. Clinical, demographic, and laboratory data were collected. The uric acid index was calculated as Ln [triglycerides × uric acid × glucose/2]. Univariable and hierarchical multiple logistic regression analyses were performed.
Results: Seventy-one patients (27.5%) showed ≥50% stenosis. Those with stenosis were older and had higher Agatston scores, creatinine, uric acid, glucose, HbA1c, and lower high-density lipoprotein cholestrol (HDL-C). In the final multiple models adjusted for age, sex, creatinine and Agatston score, the uric acid index remained a strong independent predictor of ≥50% stenosis (odds ratio [OR] = 1.988, P = .019, 95% confidence interval [CI] = 1.117-3.538). The index demonstrated significant incremental predictive value over the base model, with a Net Reclassification Improvement (NRI) of 0.500 (P < .05) and an Integrated Discrimination Improvement (IDI) of 0.029. The area under the curve for the uric acid index (0.688) exceeded that of uric acid (0.664).
Conclusion: In a real-world coronary CT angiography cohort, the composite uric acid index independently predicted significant coronary stenosis. Its incremental predictive value requires validation in larger, prospective studies.