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Open Access Highly Accessed Research article

A cross-sectional analysis of the relationship between uric acid and coronary atherosclerosis in patients with suspected coronary artery disease in China

Yujiao Sun1, Xin Yu1, Ying Zhi1, Song Geng1, Hua Li1, Ting Liu2, Ke Xu2, Ling Chen1, Chunwei Wu1 and Guoxian Qi1*

Author Affiliations

1 Department of Cardiology of Aging, Department of Cardiology, The First Affiliated Hospital of China Medical University, NO.155 Nanjing North Street, Heping Ward, Shenyang 110001, China

2 Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China

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BMC Cardiovascular Disorders 2014, 14:101  doi:10.1186/1471-2261-14-101

Published: 16 August 2014



Although many studies have examined the relationship between uric acid (UA) and coronary artery disease (CAD), whether UA is an independent risk factor contributing to progression of CAD is still controversial. Whether UA plays a different role in different sexes is also unclear.


A total of 1116 individuals with suspected CAD were stratified into four groups according to their serum UA quartiles in total (men and women combined), in men, and in women. The association of UA with coronary atherosclerosis was assessed by univariable and multivariable logistic regression.


In total and in women, the prevalence of any plaques and significant/severe stenosis was significantly increased with an increase in quartiles of UA (all P < 0.05). The proportion of triple-vessel disease and left main artery lesion was highest in the fourth quartile (both p < 0.05). Increasing quartiles of UA were significantly associated with a coronary artery calcium score (CACS) >10 (all P < 0.01). As UA levels increased in women, the incidence of double-vessel lesions (p = 0.017) and the proportion of mixed plaques (p = 0.022) were significantly increased. The proportion of a CACS of 0 in total, in men and women was highest in the first quartile (all P < 0.01). UA was the strongest predictor of significant stenosis, multivessel disease, and mixed plaques in women (all p < 0.05). UA was the only risk factor for mixed plaques in total (P = 0.046).


The level of UA was significantly associated with coronary atherosclerosis in women, but not men.

Uric acid; Coronary atherosclerosis; Coronary computed tomography angiography; Gender; Calcium score