Uric acid is associated with future atrial fibrillation: an 11-year follow-up of 6308 men and women--the Tromso Study

Nyrnes, Audhild; Toft, Ingrid; Njølstad, Inger; Mathiesen, Ellisiv B.; Wilsgaard, Tom; Hansen, John‐Bjarne; Løchen, Maja‐Lisa

doi:10.1093/europace/eut260

Cited by 61 publications

(62 citation statements)

References 29 publications

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“…A previous study from our group showed that elevated baseline UA is associated with increased risk of atrial fibrillation, 27 and another study recently demonstrated that LA size ≥2.8 cm/m 2 was significantly associated with increased risk of incident atrial fibrillation.…”

Section: Left Atrium Sizementioning

confidence: 71%

Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013

et al. 2017

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Aims To investigate whether serum uric acid predicts adverse outcomes in persons with indices of diastolic dysfunction in a general population. Methods and resultsWe performed a prospective cohort study among 1460 women and 1480 men from 1994 to 2013. Endpoints were all-cause mortality, incident myocardial infarction, and incident ischaemic stroke. We stratified the analyses by echocardiographic markers of diastolic dysfunction, and uric acid was the independent variable of interest. Hazard ratios (HR) were estimated per 59 μmol/L increase in baseline uric acid. Multivariable adjusted Cox proportional hazards models showed that uric acid predicted all-cause mortality in subjects with E/A ratio <0.75 (HR 1.12, 95% confidence interval [CI] 1.00-1.25) or E/A ratio >1.5 (HR 1.51, 95% CI 1.09-2.09, P for interaction between E/A ratio category and uric acid = 0.02). Elevated uric acid increased mortality risk in persons with E-wave deceleration time <140 ms or >220 ms (HR 1.46, 95% CI 1.01-2.12 and HR 1.13, 95% CI 1.02-1.26, respectively; P for interaction = 0.04). Furthermore, in participants with isovolumetric relaxation time ≤60 ms, mortality risk was higher with increasing uric acid (HR 4.98, 95% CI 2.02-12.26, P for interaction = 0.004). Finally, elevated uric acid predicted ischaemic stroke in subjects with severely enlarged left atria (HR 1.62, 95% CI 1.03-2.53, P for interaction = 0.047). Conclusions Increased uric acid was associated with higher all-cause mortality risk in subjects with echocardiographic indices of diastolic dysfunction, and with higher ischaemic stroke risk in persons with severely enlarged left atria.

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Section: Left Atrium Sizementioning

confidence: 71%

Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013

et al. 2017

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“…44 Another study reported that hyperuricemia was a significant predictor of stroke in a population of patients suffering from atrial fibrillation. 45 UA might potentially trigger arrhythmia as an endogenous danger signal.…”

Section: Discussionmentioning

confidence: 99%

Uric Acid and Cardiovascular Events

Kleber

Delgado

Grammer

et al. 2015

Journal of the American Society of Nephrology

239

156

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Obesity and diets rich in uric acid-raising components appear to account for the increased prevalence of hyperuricemia in Westernized populations. Prevalence rates of hypertension, diabetes mellitus, CKD, and cardiovascular disease are also increasing. We used Mendelian randomization to examine whether uric acid is an independent and causal cardiovascular risk factor. Serum uric acid was measured in 3315 patients of the Ludwigshafen Risk and Cardiovascular Health Study. We calculated a weighted genetic risk score (GRS) for uric acid concentration based on eight uric acid-regulating single nucleotide polymorphisms. Causal odds ratios and causal hazard ratios (HRs) were calculated using a two-stage regression estimate with the GRS as the instrumental variable to examine associations with cardiometabolic phenotypes (cross-sectional) and mortality (prospectively) by logistic regression and Cox regression, respectively. Our GRS was not consistently associated with any biochemical marker except for uric acid, arguing against pleiotropy. Uric acid was associated with a range of prevalent diseases, including coronary artery disease. Uric acid and the GRS were both associated with cardiovascular death and sudden cardiac death. In a multivariate model adjusted for factors including medication, causal HRs corresponding to each 1-mg/dl increase in genetically predicted uric acid concentration were significant for cardiovascular death (HR, 1.77; 95% confidence interval, 1.12 to 2.81) and sudden cardiac death (HR, 2.41; 95% confidence interval, 1.16 to 5.00). These results suggest that high uric acid is causally related to adverse cardiovascular outcomes, especially sudden cardiac death.

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“…Whether or not gout is present, elevated SUA level is associated with cardiovascular diseases such as hypertension [14], coronary heart disease [19][20][21], AF [24,26], and stroke [22,23]. Previous studies have suggested that this correlation could be due to endothelial dysfunction, local oxidant generation, elevated vascular smooth cell proliferation, and reduced vascular nitric oxide production induced by SUA [28][29][30].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a correlation was recently detected between hyperuricemia and the development of new-onset AF and increased risk of ischemic stroke in patients with AF [24][25][26][27]. Previous studies suggested associations between hyperuricemia and endothelial dysfunction [28], local oxidant generation, and elevated circulating levels of systemic inflammatory mediators [29,30].…”

Section: Introductionmentioning

confidence: 96%

Usefulness of the uric acid and CHA2DS2-VASc score in prediction of left atrial thrombosis in patients with mitral stenosis and sinus rhythm

et al. 2015

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Background: The risk of thrombus formation in the left atrium is known to be very high in patients with both mitral stenosis (MS) and atrial fibrillation (AF). However, that risk should not be ignored in patients with MS in sinus rhythm (SR). The aim of this study was to determine the clinical, echocardiographic, and biochemical factors that could have a determining role in the formation of a left atrial (LA) thrombus in patients with MS in SR. Method: A total of 207 consecutive patients with MS who underwent both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for diagnosis or to MS in SR. (Cardiol J 2015; 22, 3: 336-342)

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Uric acid is associated with future atrial fibrillation: an 11-year follow-up of 6308 men and women--the Tromso Study

Abstract: This prospective population-based cohort study showed that baseline SUA was associated with an increased risk for future AF in both sexes.

Cited by 61 publications

References 29 publications

Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013

Uric acid predicts mortality and ischaemic stroke in subjects with diastolic dysfunction: the Tromsø Study 1994–2013

Uric Acid and Cardiovascular Events

Usefulness of the uric acid and CHA2DS2-VASc score in prediction of left atrial thrombosis in patients with mitral stenosis and sinus rhythm

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