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Background Hyperuricemia is associated with worse outcomes of patients with chronic heart failure (HF). However, it is unknown in an unselected HF patients encountered in routine clinical practice. We thus assessed the impact of hyperuricemia on long-term outcomes including mortality and rehospitalization among patients hospitalized with worsening HF. Methods The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of hospitalized HF patients and the outcomes were followed for 2.1years after discharge. Study cohorts (n=1869) were divided into 2 groups according to serum uric acid (UA) at discharge; ≥7.4mg/dL (n=908) and Results Of the total cohort of HF patients, 56% had hyperuricemia defined as UA≥7.0mg/dl. Patients with UA≥7.4mg/dL had higher rates of all-cause death, cardiac death, rehospitalization, and all-cause death or rehospitalization due to worsening HF. After multivariable adjustment, higher UA levels were a significant and independent predictor for all-cause death (adjusted hazard ratio [HR] 1.413, 95% confidence interval [CI] 1.094–1.824, P=0.008) and cardiac death (adjusted HR 1.399, 95% CI 1.020–1.920, P=0.037). Conclusions Hyperuricemia was common in patients with HF encountered in clinical practice and higher UA was independently associated with long-term adverse outcomes in these patients.

The effect of sex on the etiology, risk factors, comorbidities, treatment and prognosis in patients with heart failure (HF) encountered in routine clinical practice in Asian populations has not been well described. The objective of the present study was to elucidate sex differences with respect to the clinical characteristics, treatment, and prognosis of HF patients treated in routine clinical practice settings using the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) database, which is a nationwide registry for hospitalized patients with HF in Japan. JCARE-CARD enrolled 2675 patients hospitalized for HF at 164 participating hospitals from January 2005 to June 2006. HF was diagnosed by the simultaneous presence of at least two major criteria or onemajor criterion in conjunctionwith twominor criteria by use of the criteria from the Framingham Heart Study [1]. For each patient, baseline data recorded on the form were: demography; HF causes; comorbidities; complications; clinical status; echocardiographic findings; plasma B-type natriuretic peptide (BNP); and treatments. Longterm follow-up data could be obtained from 2305 patients after hospital discharged. Mean post-discharge follow-up was 2.3±0.7 years.