Distribution Patterns of Uric Acid in Coronary Artery Disease

The uric acid levels in each of 335 cardiac patients were studied over a period of more than 3 months from the onset of the acute stage of coronary heart disease. Comparison was made with uric acid values obtained from a group of 316 normal subjects. Male patients with arteriosclerotic coronary artery disease with infarction generally exhibited rising concentrations of serum uric acid during the first weeks after an attack and a gradual return toward normal levels after 3 months. Female patients of the two groups studied and male patients with arteriosclerotic coronary artery disease, but without infarction, had uric acid levels averaging much higher than those of the control group. ELEVATED SERUM URIC ACID LEVELS have been associated with gout. Gen-erally, people with low levels do not suffer from gout, but not all of the individuals with high uric acid levels have the disease. Uric acid is introduced into the body primarily as a major component of nucleic acid breakdown. In diseases in which there is much nucleic acid turnover, such as leukemia and polycythemia vera, gout is often observed as a secondary finding (1). Because men as a group have higher uric acid levels than women, gout is essentially a disease of men. Coronary heart disease is also essentially a disease of men, and the incidence of gout among coronary heart disease patients is known to be high. During a screening of patients admitted to our hospital in the ex-pectation of studying certain aspects of gout, it was found that almost all patients exhibiting symptoms of gout had been admitted with acute symptoms of arteriosclerotic coronary artery disease. Several early investigators have reported that high uric acid levels were often ob-served with heart diseases (2-4), but there was no systematic study of this problem. Later, Gertler et al. (5) obtained an index as a function of serum urate and lipid levels and by coupling these data with bod