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10 Alisertib Myths Totally Exposed

Difficulties in determining whether UA should be considered a cardiovascular risk factor may be explained by its frequent association with other cardiovascular risk factors [3] for which UA is considered as a risk marker or epiphenomenon or even an adaptive change to protect from atherosclerosis due to its antioxidant properties [4] and the controversial and conflicting findings from epidemiological studies [3, 5, 6]. Apart from disputable causality, other aspects of the association between UA and cardiovascular disease remain poorly understood. Although a threshold effect in the association between UA and mortality has been described [7, 8], the best cut-offs of UA for prediction of mortality remain unknown. A ��J-shaped�� association pattern between UA level and mortality (with an increase in mortality for lower and higher UA levels) has been described in population-based studies [9] and in various Alisertib disease states [10-12]. However, the pattern of association between UA and mortality and the most optimal UA levels associated with lowest mortality in patients with coronary artery disease (CAD) remain Selleck Cabozantinib unknown, even though a stronger association between UA and mortality in patients with a CAD history has been reported [13, 14]. Moreover, conflicting results have been reported regarding the association between UA and mortality in subgroups according to sex [5, 15], diabetes [16, 17] and kidney disease [18]. Despite data suggesting that elevated UA levels cause endothelial dysfunction [19] and may promote atherosclerosis and vascular thrombosis [20, 21], evidence regarding the association between UA and myocardial infarction remains controversial [21, 22]. We undertook this study in a large series of patients with CAD with a double objective: first, to assess the pattern of association between UA level and cardiac or all-cause mortality and find the most optimal UA levels Tofacitinib mouse associated with lowest mortality in patients with CAD; and second, to assess the strength of association between UA and mortality in various subgroups of patients with CAD. Between March 2000 and December 2009, 14?713 consecutive patients with CAD underwent diagnostic angiography and percutaneous coronary intervention (PCI) in the Deutsches Herzzentrum in Munich. Those eligible for the study were patients with the clinical diagnosis of stable CAD or acute coronary syndromes (ACS) in whom the presence of significant CAD was confirmed by coronary angiography. Patients with no UA measurements (832 patients), acute infections (130 patients), renal disease (serum creatinine level ��?2?mg/dL; 312 patients) and known malignancies with life expectancy <?1?year (166 patients) were excluded. Thus, the present study included 13?273 patients with angiographic confirmation of significant CAD and UA measurements available.</div>
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