Abstract

Introduction

• Heart failure is a burgeoning problem worldwide and its prevalence increases with increasing age.
• Coronary artery disease accounts for substantial portion of patients with chronic heart failure.
• Heart failure is associated with increase in circulating levels of BNP(Brain Natriuretic Peptide) and other markers like uric acid, troponin T and I , C-reactive protein, TNF receptors etc.,
• As heart failure is leading cause of mortality, ability to predict prognosis is essential for treatment purposes.
• Studies have shown that apart from BNP, serum uric acid is found to have prognostic value as well.
• Increased uric acid levels are associated with impairment of vascular nitric oxide causing increased vascular tone and depressed myocardial contractility via increase in xanthine oxidase activity and therefore associated with hemodynamic compromise in heart failure. 
• Tamariz et al. in a meta analysis with 1456 patients found the estimated threshold for serum uric acid level as 6.5mg/dl.
• A linear association was found between serum uric acid levels and mortality after 7mg/dl.
• Other studies also shown that uric acid is independent marker of poor prognosis in patients with heart failure.
• Therefore uric acid is considered as biomarker in heart failure.