0000000000903536

AUTHOR

Andrea Ungar

showing 11 related works from this author

Hyperuricemia and Risk of Cardiovascular Outcomes: The Experience of the URRAH (Uric Acid Right for Heart Health) Project

2020

The latest European Guidelines of Arterial Hypertension have officially introduced uric acid evaluation among the cardiovascular risk factors that should be evaluated in order to stratify patient's risk. In fact, it has been extensively evaluated and demonstrated to be an independent predictor not only of all-cause and cardiovascular mortality, but also of myocardial infraction, stroke and heart failure. Despite the large number of studies on this topic, an important open question that still need to be answered is the identification of a cardiovascular uric acid cut-off value. The actual hyperuricemia cut-off (> 6 mg/dL in women and 7 mg/dL in men) is principally based on the saturation …

0301 basic medicineMaleTime FactorsDiseaseUric acid.chemistry.chemical_compound0302 clinical medicineRisk FactorsUric Acid Cardiovascular events epidemiologyEpidemiologyMulticenter Studies as TopicHyperuricemiaStrokeCardiovascular events; Cardiovascular mortality; Uric acid; URRAHMiddle AgedPrognosisObservational Studies as TopicItalyCardiovascular DiseasesResearch DesignFemaleCardiology and Cardiovascular MedicineAdultmedicine.medical_specialtyCardiovascular mortalityUric acid · Cardiovascular mortality · Cardiovascular events · URRAHContext (language use)Cardiovascular eventHyperuricemiaRisk AssessmentCardiovascular events03 medical and health sciencesURRAHcardiovascular events; cardiovascular mortality; urrah; uric acidPharmacotherapyInternal medicineInternal MedicinemedicineHumansAgedRetrospective Studiesbusiness.industrymedicine.disease030104 developmental biologychemistryHeart failureUric acidbusinessUric acid030217 neurology & neurosurgeryCardiovascular events; Cardiovascular mortality; Uric acid; URRAH; Adult; Aged; Biomarkers; Cardiovascular Diseases; Female; Humans; Hyperuricemia; Italy; Male; Middle Aged; Multicenter Studies as Topic; Observational Studies as Topic; Prognosis; Research Design; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Uric AcidBiomarkers
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The association of uric acid with mortality modifies at old age: data from the uric acid right for heart health (URRAH) study

2021

Objectives: In older individuals, the role of serum uric acid (SUA) as risk factor for mortality is debated. This study investigated the association of SUA with all-cause and cardiovascular (CV) mortality in older adults participating in the large multicentre observational uric acid right for heart health (URRAH) study. Methods: Eight thousand URRAH participants aged 65+ were included in the analysis. The predictive role of SUA was assessed using Cox regression models stratified according to the cut-off age of 75. SUA was tested as continuous and categorical variable (age-specific quartiles). The prognostic threshold of SUA for mortality was analysed using receiver operating characteristic …

Settore MED/09 - Medicina InternahypertensionPhysiologyAged; Humans; Prognosis; Proportional Hazards Models; Risk Factors; Uric Aciduric acid; hypertension; elderly; cardiovascular prevention; stroke; myocardial infarctionAcid Urc mortality old agePrognosisCardiovascular riskelderlystrokeolder adultCardiovascular preventionmyocardial infarctionRisk FactorsOlder adultsCardiovascular prevention; Cardiovascular risk; Mortality; Older adults; Uric acidInternal MedicineHumansMortalityCardiology and Cardiovascular MedicineUric acidAgedProportional Hazards Models
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Identification of a plausible serum uric acid cut-off value as prognostic marker of stroke: the Uric Acid Right for Heart Health (URRAH) study

2021

The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension conceived and designed an ad hoc study aimed at searching for prognostic cut-off values of serum uric acid (SUA) in predicting combined (fatal and non-fatal) cerebrovascular (CBV) events in the whole database. The URic acid Right for heArt Health study is a nationwide, multicenter, observational cohort study involving data on subjects aged 18-95 years recruited on a regional community basis from all the territory of Italy under the patronage of the Italian Society of Hypertension with a mean follow-up period of 120.7 ± 61.8 months. A total of 14,588 subjects were included in the analysis. A prognos…

medicine.medical_specialtySettore MED/09 - Medicina Internauric acid cardiovascular riskserum uric acid; stroke; hypertension; cardiovascular prevention; cardiovascular diseasechemistry.chemical_compoundRisk FactorsInternal medicineDiabetes mellitusInternal MedicinemedicineHumansStrokeuric acid hypertensionbusiness.industryConfoundingPrognosismedicine.diseaseConfidence intervalUric AcidStrokechemistryHypertensionUric acidbusinessBody mass indexCohort studyKidney disease
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Serum Uric Acid and Kidney Disease Measures Independently Predict Cardiovascular and Total Mortality: The Uric Acid Right for Heart Health (URRAH) Pr…

2021

Background: Serum uric acid predicts the onset and progression of kidney disease, and the occurrence of cardiovascular and all-cause mortality. Nevertheless, it is unclear which is the appropriate definition of hyperuricemia in presence of chronic kidney disease (CKD). Our goal was to study the independent impact of uric acid and CKD on mortality.Methods: We retrospectively investigated 21,963 patients from the URRAH study database. Hyperuricemia was defined on the basis of outcome specific cut-offs separately identified by ROC curves according to eGFR strata. The primary endpoints were cardiovascular and all-cause mortality.Results: After a mean follow-up of 9.8 year, there were 1,582 (7.2…

medicine.medical_specialtyhyperuricemiaCardiovascular Medicineurologic and male genital diseasesGastroenterologyalbuminuriachemistry.chemical_compoundcardiovascular mortalityInternal medicinemedicineeGFRDiseases of the circulatory (Cardiovascular) systemHyperuricemiaRisk factorOriginal Researchbusiness.industryIncidence (epidemiology)Confoundingalbuminuria; all-cause mortality; cardiovascular mortality; eGFR; hyperuricemiahyperuricemia eGFR albuminuria cardiovascular mortality all-cause mortalitymedicine.diseasechemistryQuartileRC666-701AlbuminuriaUric acidall-cause mortalitymedicine.symptomCardiology and Cardiovascular MedicinebusinessKidney disease
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Identification of the Uric Acid Thresholds Predicting an Increased Total and Cardiovascular Mortality Over 20 Years

2020

Serum uric acid (SUA) levels discriminating across the different strata of cardiovascular risk is still unknown. By utilizing a large population-based database, we assessed the threshold of SUA that increases the risk of total mortality and cardiovascular mortality (CVM). The URRAH study (Uric Acid Right for Heart Health) is a multicentre retrospective, observational study, which collected data from several large population-based longitudinal studies in Italy and subjects recruited in the hypertension clinics of the Italian Society of Hypertension. Total mortality was defined as mortality for any cause, CVM as death due to fatal myocardial infarction, stroke, sudden cardiac death, or heart…

Malemedicine.medical_specialtySettore MED/09 - Medicina Internaepidemiology; heart failure; humans; risk; uric acid; Cause of Death; Female; Humans; Italy; Male; Middle Aged; Mortality; Practice Patterns Physicians'; Quality Improvement; Risk Assessment; Risk Factors; Uric Acid; Cardiovascular Diseases; Hypertension; Hyperuricemiaheart failurePractice PatternsHyperuricemia030204 cardiovascular system & hematologyepidemiology; heart failure; humans; risk; uric acidRisk AssessmentSudden cardiac death03 medical and health sciences0302 clinical medicineuric acidRisk FactorsInternal medicineCause of DeathEpidemiologyInternal MedicineMedicine030212 general & internal medicineHyperuricemiaMyocardial infarctionhumanMortalityPractice Patterns Physicians'humansStrokeriskEpidemiology heart failure humans risk uric acid.Physicians'business.industryProportional hazards modelHazard ratioUric acid cardiovascular mortality epidemiologyMiddle Agedmedicine.diseaseQuality ImprovementItalyCardiovascular DiseasesHeart failureHypertensionFemaleepidemiologybusiness
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An Expert Opinion From the European Society of Hypertension–European Union Geriatric Medicine Society Working Group on the Management of Hypertension…

2016

Two years after the publication of the 2013 guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC),1 the ESH and the European Union Geriatric Medicine Society have created a common working group to examine the management of hypertensive subjects aged >80 years. The general term hypertension in the elderly is not sufficiently accurate because it mixes younger old patients (60–70 years) with the oldest old. Our group believes that the management of hypertension in individuals aged ≥80 years should be specifically addressed. Although arbitrary, this cutoff value identifies a population that is expanding …

MaleGerontologyBLOOD-PRESSUREL-ARGININE TRANSPORTFAT-FED RABBITS030204 cardiovascular system & hematologySeverity of Illness IndexSYMPATHETIC-NERVE ACTIVITY0302 clinical medicine80 and overPerindopril030212 general & internal medicineDisease management (health)Societies MedicalComputingMilieux_MISCELLANEOUSMETABOLIC SYNDROMEmedia_commonAged 80 and overGeriatricseducation.field_of_study[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology[SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontologyIndapamideDisease ManagementPrognosis[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system3. Good healthAntihypertensive AgentTreatment OutcomeHypertensionPractice Guidelines as TopicFemaleSurvival AnalysiHumanmedicine.drugANGIOTENSIN-CONVERTING ENZYMEmedicine.medical_specialtyPrognosiFrail ElderlyeducationPopulationRisk Assessment03 medical and health sciences[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemMedicalInternal MedicinemedicineHumansmedia_common.cataloged_instanceEuropean UnionNITRIC-OXIDE SYNTHASEEuropean unioneducationREDUCES OXIDATIVE STRESSExpert TestimonyGeriatric AssessmentAntihypertensive AgentsAgedAged; Aged 80 and over; Antihypertensive Agents; Blood Pressure Determination; Disease Management; European Union; Expert Testimony; Female; Frail Elderly; Geriatric Assessment; Geriatrics; Humans; Hypertension; Male; Prognosis; Risk Assessment; Severity of Illness Index; Societies Medical; Survival Analysis; Treatment Outcome; Practice Guidelines as Topic; Internal Medicinebusiness.industryBlood Pressure DeterminationSurvival AnalysisBlood pressureOBESITY-INDUCED HYPERTENSIONGeriatrics3121 General medicine internal medicine and other clinical medicineENDOTHELIAL DYSFUNCTIONLife expectancySocietiesbusinessGeriatric[SDV.MHEP]Life Sciences [q-bio]/Human health and pathologyHypertension
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High heart rate amplifies the risk of cardiovascular mortality associated with elevated uric acid.

2021

Abstract Aims  Whether the association between uric acid (UA) and cardiovascular disease is influenced by some facilitating factors is unclear. The aim of this study was to investigate whether the risk of cardiovascular mortality (CVM) associated with elevated UA was modulated by the level of resting heart rate (HR). Methods and results  Multivariable Cox analyses were made in 19 128 participants from the multicentre Uric acid Right for heArt Health study. During a median follow-up of 11.2 years, there were 1381 cases of CVM. In multivariable Cox models both UA and HR, either considered as continuous or categorical variables were independent predictors of CVM both improving risk discriminat…

medicine.medical_specialtySympathetic nervous systemLongitudinal studyEpidemiologyHeart rate030204 cardiovascular system & hematologyCardiovascular03 medical and health scienceschemistry.chemical_compound0302 clinical medicineInternal medicineHeart rateSympathetic activityMedicine030212 general & internal medicineRisk factorMortalityProportional hazards modelbusiness.industryHazard ratioConfidence intervalmedicine.anatomical_structurechemistryCardiologyUric acidCardiovascular; Heart rate; Longitudinal study; Mortality; Sympathetic activity; Uric acidLongitudinal studyCardiology and Cardiovascular MedicinebusinessUric acidEuropean journal of preventive cardiology
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Serum uric acid levels threshold for mortality in diabetic individuals: The URic acid Right for heArt Health (URRAH) project

2022

Background and aim: The URRAH (URic acid Right for heArt Health) Study has identified cut-off values of serum uric acid (SUA) predictive of total mortality at 4.7 mg/dl, and cardiovascular (CV) mortality at 5.6 mg/dl. Our aim was to validate these SUA thresholds in people with diabetes. Methods and results: The URRAH subpopulation of people with diabetes was studied. All-cause and CV deaths were evaluated at the end of follow-up. A total of 2570 diabetic subjects were studied. During a median follow-up of 107 months, 744 deaths occurred. In the multivariate Cox regression analyses adjusted for several confounders, subjects with SUA ≥5.6 mg/dl had higher risk of total (HR: 1.23, 95%CI: 1.04-…

Diabetes mellituNutrition and DieteticsSettore MED/09 - Medicina InternaCardiovascular mortalitySerum uric acid Cardiovascular mortality All-cause mortality Diabetes mellitus Hyperuricemia Diagnostic thresholdsEndocrinology Diabetes and MetabolismMedicine (miscellaneous)HyperuricemiaAll-cause mortalityUric AcidDiagnostic thresholdsall-cause mortality; cardiovascular mortality; diabetes mellitus; diagnostic thresholds; hyperuricemia; serum uric acid; humans; risk factors; uric acid; diabetes mellitus; hyperuricemiaDiagnostic thresholdDiabetes mellitusSerum uric acidRisk FactorsAll-cause mortality; Cardiovascular mortality; Diabetes mellitus; Diagnostic thresholds; Hyperuricemia; Serum uric acidHumansCardiology and Cardiovascular Medicine
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Serum uric acid, predicts heart failure in a large Italian cohort: search for a cut-off value the URic acid Right for heArt Health study

2020

Objective: To assess the prognostic cut-off values of serum uric acid (SUA) in predicting fatal and morbid heart failure in a large Italian cohort in the frame of the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension. Methods: The URic acid Right for heArt Health (URRAH) study is a nationwide, multicentre, cohort study involving data on individuals aged 18-95 years, recruited on a community basis from all regions of Italy under the patronage of the Italian Society of Hypertension with a mean follow-up period of 128 ± 65 months. Incident heart failure was defined on the basis of International Classification of Diseases Tenth Revision codes and double-c…

medicine.medical_specialtySettore MED/09 - Medicina InternaPhysiologyEpidemiologyCut-off value030204 cardiovascular system & hematologyCohort Studies03 medical and health sciences0302 clinical medicineRisk FactorsInternal medicineDiabetes mellitusInternal MedicineMedicineHumans030212 general & internal medicineMortalityRisk factorCut-off value heart failure mortality uric acidHeart Failurebusiness.industryProportional hazards modelHazard ratioConfoundingcut-off value; heart failure; mortality; uric acidmedicine.diseaseUric AcidItalyHeart failureCohortHypertensionCardiologyCardiology and Cardiovascular MedicinebusinessCohort study
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Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016

2019

Objective This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy w…

Malediagnosismedications0302 clinical medicinepreventionAged 80 and over; Delirium; Drug Prescriptions; Female; Hospital Departments; Humans; Male; Prevalence; Polypharmacy; Prescription Drugs80 and overPrevalenceMedicineLS4_4030212 general & internal medicineAcute hospitalmedia_commonAged 80 and overConfoundingelderly patients hip fracture hospitalized patients prediction rule risk factor dementia events medications prevention diagnosisrisk-factorrisk factorhip fracturePsychiatry and Mental HealthFemalemedicine.symptomeventsDrugmedicine.medical_specialtyPrescription Drugshospitalized-patientsmedia_common.quotation_subjectMEDLINEHospital DepartmentsSocio-culturaleelderly-patientselderly patientsbehavioral disciplines and activitiesDrug Prescriptions03 medical and health sciencesInternal medicinemental disordersDementiaHumansMedical prescriptionprediction ruleAgedPolypharmacybusiness.industryhospitalized patientsDeliriummedicine.diseasenervous system diseasesPolypharmacyDeliriumelderly-patients; hip fracture; hospitalized-patients; prediction rule; risk-factor; dementia; events; medications; prevention; diagnosisbusiness030217 neurology & neurosurgerydementia
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"Delirium Day": a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

2016

Background To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods This is a point prevalence study (called “Delirium Day”) including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium wa…

MaleCross-sectional studyHospitalized patientsPrevalence0302 clinical medicineSurveys and Questionnaires80 and overOdds RatioPrevalenceMedicine030212 general & internal medicineProspective StudiesProspective cohort studyMulticenterAcute hospital2. Zero hungerAged 80 and overMedicine(all)Medicine (all)Settore BIO/14General Medicine3. Good health4AT; Delirium; Hospital; Multicenter; Prevalence; Aged; Aged 80 and over; Cross-Sectional Studies; Delirium; Female; Humans; Inpatients; Italy; Logistic Models; Male; Odds Ratio; Prevalence; Prospective Studies; Surveys and QuestionnairesItalyFemalemedicine.symptomResearch ArticleRehabilitation hospitalmedicine.medical_specialty4AT; Delirium; Hospital; Multicenter; Prevalence; Aged; Aged 80 and over; Cross-Sectional Studies; Delirium; Female; Humans; Inpatients; Italy; Logistic Models; Male; Odds Ratio; Prevalence; Prospective Studies; Surveys and Questionnaires; Medicine (all)NO03 medical and health sciencesHospital4AT Delirium Hospital Multicenter Prevalence Aged Aged 80 and over Cross-Sectional Studies Delirium Female Humans Inpatients Italy Logistic Models Male Odds Ratio Prevalence Prospective Studies Surveys and Questionnairesmental disordersHumans4ATPsychiatry4AT; Delirium; Hospital; Multicenter; Prevalence;AgedInpatientsbusiness.industryDeliriumOdds ratio4AT; Delirium; Hospital; Multicenter; Prevalence; Medicine (all)Cross-Sectional StudiesLogistic ModelsEmergency medicineDeliriumDelirium; Prevalence; Hospital; Multicenter; 4ATbusiness030217 neurology & neurosurgery
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