Panminerva Medica 2021 Mar 26

DOI: 10.23736/S0031-0808.21.04357-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

The Urrah study

Rita DEL PINTO ¹, Francesca VIAZZI ², Roberto PONTREMOLI ², Claudio FERRI ¹ ✉, Francesco CARUBBI ¹, Elisa RUSSO ²

¹ Dipartimento Medicina Clinica, Sanità Pubblica, Scienza della Vita e dell’Ambiente, Università degli Studi dell’Aquila, L'Aquila, Italy; ² Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Genova, Italy

Uric acid has long been considered responsible for a single specific disease, namely gout. In recent years, novel knowledge has emerged linking serum uric acid with a variety of conditions and related risk factors, from hypertension, metabolic syndrome, and type 2 diabetes, to fatal/nonfatal cardiovascular diseases and all-cause death, with the underlying mechanisms involving disrupted neurohormonal and metabolic signaling as well as oxidative stress and inflammation. Importantly, the cut-off value of serum uric acid predicting the risk of incident events is within the range of normality and below the threshold for increased risk of gout. A large contribution to the advancement in knowledge in the cardiovascular implications of uric acid derives from the Italian study URic acid Right for heArt Health (URRAH). This review summarizes the mechanisms linking uric acid with cardiovascular risk and the major findings of the URRAH study. The need for a reappraisal of the definition of range of normality for uric acid is discussed.

KEY WORDS: Uric acid; Cardiovascular risk; Mortality