Serum Uric Acid to Creatinine Ratio as a Predictor of Coronary Heart Disease: A Research Update

Serum uric acid (SUA), the end-product of purine metabolism, functions as an important antioxidant and participates in multiple metabolic pathways. Accumulating evidence has demonstrated that SUA is closely associated with the initiation and progression of cardiovascular events and is considered an independent predictor of various vascular diseases. Elevated SUA can induce vascular endothelial dysfunction, accelerate atherogenesis and ultimately result in coronary heart disease (CHD). However, SUA concentrations are largely influenced by renal function; consequently, impaired renal function frequently increases SUA levels and limits the ability of SUA alone to reflect the true metabolic burden. Recently, the SUA-to-creatinine ratio (SUA/Cr), which normalizes SUA for renal function, has been proposed as a superior indicator of net SUA production. Thus, SUA/Cr provides a more accurate prediction of coronary artery disease severity in patients with CHD.