High Serum Uric Acid Level Independently Predicts Non-Calcified Plaques

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Serum uric acid level was an independent predictor of non-calcified plaques on coronary computed tomography angiography in asymptomatic individuals after adjusting for cardiovascular risk factors.

In patients with subclinical coronary atherosclerosis, higher levels of serum uric acid (SUA) are associated with an increased risk for non-calcified plaques, according to study results published in Atherosclerosis.

The study included asymptomatic patients with coronary atherosclerosis with no prior history of coronary artery disease (n=6431). Patients voluntarily underwent laboratory tests and coronary computed tomography angiography (CCTA) as part of a general health examination. The researchers stratified patients into quartiles according to their SUA levels. They assessed coronary atherosclerotic plaques (calcified, mixed, and non-calcified plaques) using CCTA. To determine the association between SUA levels and subclinical coronary atherosclerosis, the researchers used logistic regression analysis.

The results indicated that the prevalence of any atherosclerotic, calcified, mixed, and non-calcified plaques increases with SUA quartiles (all P <.001).

After adjusting for cardiovascular risk factors, the researchers did not find any statistically significant differences in the adjusted odds ratios (aORs) for calcified plaque (aOR, 1.19; 95% CI, 0.98-1.46; P =.080) and mixed plaque (aOR, 1.25; 95% CI 0.94-1.67; P =.132) in the fourth SUA quartile compared with the first quartile. However, they found that patients in the fourth SUA quartile had significantly higher aORs for any atherosclerotic plaque (aORs, 1.39; 95% CI, 1.16-1.68; P <.001) and non-calcified plaque (aOR, 1.38; 95% CI, 1.11-1.72; P =.004) compared with patients in the first quartile.

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“Large-scale randomized studies should be conducted to investigate the role of reduction in uric acid levels in the progression of atherosclerosis,” the researchers wrote.


Lim D, Lee Y, Park G, et al. Serum uric acid level and subclinical coronary atherosclerosis in asymptomatic individuals: an observational cohort study. Atherosclerosis. 2019;288:112-117.