Serum uric acid monitoring during aspirin-ticagrelor therapy benefits patients with kidney dysfunction, suggests study

Hyperuricemia” is the medical term for having high uric acid levels in your body. Uric acid is a waste product that’s created when your body breaks down chemicals called purines in food and drinks. Most uric acid dissolves in your blood, passes through your kidneys and leaves your body in your pee (urine). Hyperuricemia happens if too much uric acid stays in your body. Hyperuricemia causes uric acid to clump together in sharp crystals. These crystals can settle in your joints and cause gout, a painful form of arthritis. They can also build up in your kidneys and form kidney stones.

Uric acid (UA) is the end product of purine nucleotide metabolism, formed from the degradation of adenosine and guanine [8]. Serum uric acid (SUA) has been reported to be associated with atherosclerosis and metabolic syndrome [9,10]. Recent studies showed that SUA was an independent risk factor for early-onset coronary artery disease and coronary calcification

This study investigated whether serum uric acid levels are more elevated in the aspirin-ticagrelor group than in the aspirin-clopidogrel group.

The researchers conducted a retrospective cohort study with patients between 2013 and 2020. Baseline and maximum serum uric acid levels within a 6-month follow-up period were analyzed to determine the increase in both groups. A total of 41,877 patients were enrolled. A statistically significant elevation of serum uric acid levels was found in the aspirin-ticagrelor group compared to the aspirin-clopidogrel group (odds ratio (OR; 95% confidence interval (CI)) = 1.36 (1.15 - 1.60), p < 0.001).

The researchers concluded that Kidney dysfunction and diuretic use were also identified as risk factors for uric acid elevation. Therefore monitoring serum uric acid levels is recommended during aspirin-ticagrelor therapy, especially in patients with kidney dysfunction or those using diuretics.

Reference:

Park, Sojin, et al. "Comparison of Uric Acid Elevation Between Aspirin-ticagrelor and Aspirin-clopidogrel During Dual Antiplatelet Therapy." International Journal of Clinical Pharmacology and Therapeutics, 2024.