Background: Serum uric acid (SUA) has been implicated in various cardiovascular conditions. Elevated SUA levels, a condition known as hyperuricemia, are associated with oxidative stress, endothelial dysfunction, and inflammation, all of which contribute to the pathophysiology of acute coronary syndrome (ACS). This study seeks to examine the relationship between SUA levels and in-hospital outcomes in patients with ACS.

Methods: This cross-sectional study was conducted in the Coronary Care Unit (CCU) of Sohag University Hospitals, involving 150 patients diagnosed with ACS. Patients were categorized based on their SUA levels into two groups: normal uric acid (Group 1) and hyperuricemia (Group 2). Clinical evaluations, laboratory investigations, echocardiography, and coronary angiography were performed. In-hospital outcomes, including recurrent infarction, serious arrhythmias, pulmonary edema, cardiogenic shock, and sudden cardiac death, were monitored.

Results: The study included 150 patients with a mean age of 59.5 years, of whom 62% were male. Hyperuricemia was observed in 28% of the patients. The mean SUA level was significantly higher in the hyperuricemia group. In-hospital complications were significantly more prevalent in the hyperuricemia group, including higher rates of recurrent infarction (2.38%), pulmonary edema (28.57%), serious arrhythmia (11.9%), shock (21.43%), and death (7.142%). The composite outcome was significantly worse in the hyperuricemia group (66.66%) compared to the normouricemia group (6.48%).

Conclusion: Our study highlights the significant link between elevated SUA levels and adverse in-hospital outcomes in ACS patients. These findings imply that SUA could potentially function as a prognostic indicator for the severity and outcomes of ACS.