Serum Uric Acid and Atrial Fibrillation: Meta-analysis

Pak, Stella; Yatsynovich, Yan; Valencia, Damian; Chen, Tian

doi:10.1097/hpc.0000000000000150

Cited by 12 publications

(8 citation statements)

References 29 publications

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Section: Discussionmentioning

confidence: 99%

“…29 Studies have confirmed that uric acid can induce and aggravate atrial remodeling by enhancing inflammation and oxidative stress, and thereby triggering the occurrence of atrial fibrillation. 30,31 Uric acid is the end product of purine metabolism, and xanthine oxidase is the rate limiting enzyme of its synthesis. A physiological concentration of uric acid has antioxidant properties, but when uric acid enters the cell or is in the acidic/hydrophobic environment of atherosclerotic plaque, the antioxidant properties will change, and it becomes a prooxidant.…”

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confidence: 99%

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The Impact of the Duration of Cardiac Troponin I Elevation on the Clinical Prognosis as Well as Incidence of New-Onset Atrial Fibrillation Respectively in Elderly Non-ST-Elevation Acute Myocardial Infarction Patients without PCI

Wang¹,

Wang²,

Yao³

et al. 2021

JIR

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Objective This study aimed to investigate the impact of the duration of cardiac troponin I (TnI) elevation on the prognosis and incidence of new-onset atrial fibrillation (NOAF) in elderly patients with non-ST-elevation acute myocardial infarction (NSTE-AMI). Methods A total of 383 NSTE-AMI patients ≥75 years old were enrolled in this study and divided into two groups: in 194 cases, the duration of TnI elevation was ≥14 days (group 1), and in 189 cases, the duration of TnI elevation was <14 days (group 2). The patients were followed up for 60 months. The effect of TnI on prognosis was studied by cohort. The primary endpoint was a composite endpoint of cardiovascular death, reinfarction, ischemic stroke, and hospitalization for heart failure, and the secondary endpoint was all-cause death. A case–control study design was adopted to analyze the influencing factors of NOAF occurrence in Group 1 and Group 2. Results The median duration of follow-up was 26 months. Multivariate Cox’s regression analysis revealed that the duration of TnI elevation ≥14 days and diuretic use were independent variables of the major composite endpoint (p < 0.01 for both), and the left ventricular ejection fraction and the duration of TnI elevation ≥14 days were independent related variables of all-cause death (p < 0.05). The duration of TnI elevation ≥14 days was correlated with the occurrence of NOAF, but, in the multivariate logistic regression model, only uric acid and high-sensitivity C-reactive protein were independently associated with NOAF (p < 0.05). Conclusion The duration of TnI elevation ≥14 days was the independent correlation factor of the major composite endpoint and all-cause death; high sensitivity C-reactive protein and uric acid are independent risk factors for NOAF.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Impact of the Duration of Cardiac Troponin I Elevation on the Clinical Prognosis as Well as Incidence of New-Onset Atrial Fibrillation Respectively in Elderly Non-ST-Elevation Acute Myocardial Infarction Patients without PCI

Wang¹,

Wang²,

Yao³

et al. 2021

JIR

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“…AF is the most common heart rhythm disorder, and its major risk factors include advanced age, hypertension, obesity, diabetes, HF, valvular heart disease, and MI. In recent years, numerous clinical studies have confirmed that hyperuricemia is associated with AF after adjusting for various cardiovascular risk factors, and the correlation is stronger in women than in men (Liang et al, 2016;Zhang et al, 2016;Chen et al, 2017;Kuwabara et al, 2017c;Mantovani et al, 2018;Pak et al, 2018;Black-Maier and Daubert, 2019;Lin et al, 2019). The bases for sex-related differences in high UA and AF or CHD remains unknown.…”

Section: Ua and Afmentioning

confidence: 99%

Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective

2020

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Uric acid (UA) is the end product of purine nucleotide metabolism in the human body. Hyperuricemia is an abnormally high level of UA in the blood and may result in arthritis and gout. The prevalence of hyperuricemia has been increasing globally. Epidemiological studies have shown that UA levels are positively correlated with cardiovascular diseases, including hypertension, atherosclerosis, atrial fibrillation (AF), and heart failure (HF). Hyperuricemia promotes the occurrence and development of cardiovascular diseases by regulating molecular signals, such as inflammatory response, oxidative stress, insulin resistance/diabetes, endoplasmic reticulum stress, and endothelial dysfunction. Despite extensive research, the underlying molecular mechanisms are still unclear. Allopurinol, a xanthine oxidase (XO) inhibitor, has been shown to improve cardiovascular outcomes in patients with HF, coronary heart disease (CHD), type 2 diabetes (T2D), and left ventricular hypertrophy (LVH). Whether febuxostat, another XO inhibitor, can improve cardiovascular outcomes as well as allopurinol remains controversial. Furthermore, it is also not clear whether UA-lowering treatment (ULT) can benefit patients with asymptomatic hyperuricemia. In this review, we focus on the latest cellular and molecular findings of cardiovascular disease associated with hyperuricemia and clinical data about the efficacy of ULT in patients with cardiovascular disease.

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“…Considering the continuous rise in the average life expectancy in recent years and an increase in cardiac morbidity, the occurrence of AF has been increasing sharply in the past two decades. Despite advancements in the detection and management of AF, inadequate guidance persists, regarding primary prevention and risk stratification of this disease (6).…”

Section: Introductionmentioning

confidence: 99%

Does Serum Uric Acid Status Influence the Association Between Left Atrium Diameter and Atrial Fibrillation in Hypertension Patients?

Hidru

Tang

Liu

et al. 2020

Front. Cardiovasc. Med.

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Objective: Both serum uric acid (SUA) levels and left atrium diameter (LAD) associate with AF. However, the influence of SUA status for the associated risk of AF related to LAD in hypertension patients is currently unknown.Methods: We retrospectively analyzed a hospital-based sample of 9,618 hypertension patients. Standard electrocardiograms were performed on all patients and were interpreted by expert electro-physiologists.Results: Overall 1,028 (10.69%) patients had AF out of 9,618 patients. In men >65 years of age, the prevalence of AF in the1st, 2nd, and 3rd tertiles of SUA among those grouped in the third tertile of LAD were 9, 12.3, and 21.7%, respectively. In the hyperuricemia group, the OR (95% CI) of AF for the highest tertile of LAD in men ≤ 65 years of age was 3.150 (1.756, 5.651; P < 0.001). Similarly, the hyperuricemic men in the 3rd LAD tertile had a higher likelihood of AF than those belonging to the 1st tertile. The ORs and (95% CIs) were 3.150 (1.756, 5.651; P < 0.001) and 5.522 (2.932, 10.400; P ≤ 0.001) for patients ≤ 65 and >65 years of age. An increase in SUA values was significantly associated with an increased likelihood of AF among women at the top tertiles of LAD, with the OR (95% CI) = 4.593 (1.857, 11.358; P = 0.001). Also, men> 65 years of age with large LAD, present at the third tertile of SUA, had a higher likelihood of AF, with the OR (95% CI) = 2.427 (1.039, 5.667; P < 0.05).Conclusion: SUA levels and LAD are associated with AF in patients with hypertension and the risk of AF associated with LAD increases among those with hyperuricemia.

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Serum Uric Acid and Atrial Fibrillation: Meta-analysis

Cited by 12 publications

References 29 publications

The Impact of the Duration of Cardiac Troponin I Elevation on the Clinical Prognosis as Well as Incidence of New-Onset Atrial Fibrillation Respectively in Elderly Non-ST-Elevation Acute Myocardial Infarction Patients without PCI

The Impact of the Duration of Cardiac Troponin I Elevation on the Clinical Prognosis as Well as Incidence of New-Onset Atrial Fibrillation Respectively in Elderly Non-ST-Elevation Acute Myocardial Infarction Patients without PCI

Uric Acid and Cardiovascular Disease: An Update From Molecular Mechanism to Clinical Perspective

Does Serum Uric Acid Status Influence the Association Between Left Atrium Diameter and Atrial Fibrillation in Hypertension Patients?

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