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OBJECTIVES: To study the relationship between serum uric acid level and Killip classification in pateints with acute myocardial infarction (MI), and the use of serum uric acid levels as a marker of short-term mortality. METHODS: The present study involved 50 patients with acute MI and 50 controls. Serum uric acid level was measured on days 0, 3 and 7 of MI, and compared with all clinical parameters and mortality in the enrolled subjects. RESULTS: There was a statistically significant higher serum uric acid concentration in patients with MI on the day of admission compared with controls. Patients with history of MI had higher serum uric acid levels. On all days, serum uric acid levels were higher in patients who were in a higher Killip class. Two patients who died after three days of hospital stay had a serum uric acid level >7.0 gm/dL and both were in Killip class IV. CONCLUSIONS: Serum uric acid levels were higher in patients with acute MI compared with normal healthy individuals. In acute MI, patients with hyperuricemia had higher mortality. Serum uric acid levels correlated with Killip classification in patients with acute MI. Serum uric acid level can be used as a marker of short-term mortality in acute MI, and hyperuricemia may be an indicator of poor prognosis. Serum uric acid levels were elevated in acute MI patients with systemic hypertension and diabetes mellitus.