Abstract 15653: Serum Uric Acid is Related to Atrial Fibrillation
Background: Serum uric acid (SUA) is a product of xanthine oxidase (XO). Apoptosis and tissue hypoxia lead to increased purine catabolism, which, in turn, increases XO activity and subsequently SUA levels. The purpose of this study was to perform a meta-analysis to evaluate the evidence supporting an association between atrial fibrillation (AF) and SUA.
Methods: We performed a search of the MEDLINE database (1966 to May 2013) supplemented by manual searches of bibliographies of key relevant articles. We selected all cross-sectional and cohort studies in which SUA was measured and AF was reported. We calculated in cross-sectional studies the pooled standardized mean difference (SMD) of SUA between those with and without AF. In cohort studies we calculated the pooled relative risk (RR) with the corresponding 95% confidence interval (CI) for incident AF using the random-effects method.
Results: The search strategy yielded 37 studies, of which only 7 met our eligibility criteria. The 5 cross-sectional studies comprised 1592 evaluable patients of which the median heart failure population was 4%(range 0-100). The SMD of SUA for those with AF was 0.33; 95% CI 0.27-0.39 when compared to those without AF (figure). The two cohort studies evaluated 15,782 subjects free of AF. The RR of having AF for those with high SUA was 2.32 (95% CI 1.01-5.39) when compared to those with normal SUA.
Conclusions: High serum uric acid is associated with AF in both cross-sectional and cohort studies. It is unclear if SUA represents a marker of the disease or a treatment target.
Figure: SMD of cross-sectional studies
- © 2013 by American Heart Association, Inc.