Plasma xanthine oxidoreductase (XOR) activity in patients who require cardiovascular intensive care
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ORIGINAL ARTICLE
Plasma xanthine oxidoreductase (XOR) activity in patients who require cardiovascular intensive care Yusaku Shibata1 · Akihiro Shirakabe1 · Hirotake Okazaki1 · Masato Matsushita1 · Hiroki Goda1 · Shota Shigihara1 · Kazuhiro Asano1 · Kazutaka Kiuchi1 · Kenichi Tani1 · Takayo Murase2 · Takashi Nakamura3 · Nobuaki Kobayashi1 · Noritake Hata1 · Kuniya Asai1 · Wataru Shimizu4 Received: 21 January 2020 / Accepted: 10 April 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract Hyperuricemia is known to be associated with adverse outcomes in cardiovascular intensive care patients, but its mechanisms are unknown. A total of 569 emergency department patients were prospectively analyzed and assigned to intensive care (ICU group, n = 431) or other departments (n = 138). Uric acid (UA) levels were significantly higher in the intensive care patients (6.3 [5.1–7.6] mg/dl vs. 5.8 [4.6–6.8] mg/dL). The plasma xanthine oxidoreductase (XOR) activity in the ICU group (68.3 [21.2–359.5] pmol/h/mL) was also significantly higher than that in other departments (37.2 [15.1–93.6] pmol/h/mL). Intensive care patients were divided into three groups according to plasma XOR quartiles (Q1, low-XOR, Q2/Q3, normal-XOR, and Q4, high-XOR group). A multivariate logistic regression model showed that lactate (per 1.0 mmol/L increase, OR 1.326; 95%, CI 1.166–1.508, p XOR, n = 107]). The lowXOR group was defined as the patients in Q1, the normalXOR group was those in Q2 and Q3, and the high-XOR group was those in Q4. Because the normal range of XOR activity was not established yet, cutoff value of XOR activity was not clearly defined. We, therefore, defined the grouping by the reference of the report from normal volunteer (89.1 ± 55.1 pmol/h/mL) [15]. We compared age, gender, etiology, medical history (diabetes mellitus, hypertension, dyslipidemia and hyperuricemia), vital signs and status (SBP, diastolic blood pressure [DBP], HR, respiratory rate, body temperature, body mass index [BMI], and left ventricular ejection fraction [LVEF] upon admission), arterial blood gas (pH, PCO2, PO2, HCO3−, SaO2, and lactate), laboratory data (white blood cell [WBC], hemoglobin, BUN, creatinine, sodium, potassium, blood glucose [BG], C-reactive protein [CRP], and BNP), and mechanical support during the ICU stay (noninvasive positive pressure ventilation [NPPV], endotracheal intubation [ETI], intra-aortic balloon pumping (IABP), percutaneous cardiopulmonary support [PCPS], and continuous hemodiafiltration [CHDF]) among the three groups. We also compared the acute Physiology and Chronic Health Evaluation II (APACHE) score [16] among these three groups. Furthermore, in-hospital mortality was evaluated as a short-term prognosis among these three groups. We performed a multivariate logistic regression analysis to identify the factors that were significantly associated with increased XOR activity.
Statistical analyses All statistical analyses were performed using SPSS (version 22.0J, SPSS Japan Institute, Tokyo, Japan). All numerical data were
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