Marcin Wełnicki1, Iwona Gorczyca2,3, Wiktor Wójcik1, Olga Jelonek2,3, Małgorzata Maciorowska4, Beata Uziębło-Życzkowska4, Maciej Wójcik5, Robert Błaszczyk5, Renata Rajtar-Salwa6, Tomasz Tokarek6, Jacek Bil7, Michał Wojewódzki7, Anna Szpotowicz8, Małgorzata Krzciuk8, Monika Gawałko9, Agnieszka Kapłon-Cieślicka9, Anna Tomaszuk-Kazberuk10, Anna Szyszkowska10, Janusz Bednarski11, Elwira Bakuła-Ostalska11, Beata Wożakowska-Kapłon2,3, Artur Mamcarz1. 1. 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland. 2. 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland. 3. Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland. 4. Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland. 5. Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland. 6. Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland. 7. Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland. 8. Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swiętokrzyski, Poland. 9. 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland. 10. Department of Cardiology, Medical University, 15-276 Bialystok, Poland. 11. Department of Cardiology, St John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland.
Abstract
Background: Hyperuricemia is an established risk factor for cardiovascular disease, including atrial fibrillation (AF). The prevalence of hyperuricemia and its clinical significance in patients with already diagnosed AF remain unexplored. Methods: The Polish Atrial Fibrillation (POL-AF) registry includes consecutive patients with AF hospitalized in 10 Polish cardiology centers from January to December 2019. This analysis included patients in whom serum uric acid (SUA) was measured. Results: From 3999 POL-AF patients, 1613 were included in the analysis. The mean age of the subjects was 72 ± 11.6 years, and the mean SUA was 6.88 ± 1.93 mg/dL. Hyperuricemia was found in 43% of respondents. Eighty-four percent of the respondents were assigned to the high cardiovascular risk group, and 45% of these had SUA >7 mg/dL. Comparison of the extreme SUA groups (<5 mg/dL vs. >7 mg/dL) showed significant differences in renal parameters, total cholesterol concentration, and left ventricular ejection fraction (EF). Multivariate regression analysis showed that SUA >7 mg/dL (OR 1.74, 95% CI 1.32-2.30) and GFR <60 mL/min/1.73 m2 (OR 1.94, 95% CI 1.46-2.48) are significant markers of EF <40% in the study population. Female sex was a protective factor (OR 0.74, 95% CI 0.56-0.97). The cut-off point for SUA with 60% sensitivity and specificity indicative of an EF <40% was 6.9 mg/dL. Conclusions: Although rarely assessed, hyperuricemia appears to be common in patients with AF. High SUA levels may be a significant biomarker of reduced left ventricular EF in AF patients.
Background: Hyperuricemia is an established risk factor for cardiovascular disease, including atrial fibrillation (AF). The prevalence of hyperuricemia and its clinical significance in patients with already diagnosed AF remain unexplored. Methods: The Polish Atrial Fibrillation (POL-AF) registry includes consecutive patients with AF hospitalized in 10 Polish cardiology centers from January to December 2019. This analysis included patients in whom serum uric acid (SUA) was measured. Results: From 3999 POL-AFpatients, 1613 were included in the analysis. The mean age of the subjects was 72 ± 11.6 years, and the mean SUA was 6.88 ± 1.93 mg/dL. Hyperuricemia was found in 43% of respondents. Eighty-four percent of the respondents were assigned to the high cardiovascular risk group, and 45% of these had SUA >7 mg/dL. Comparison of the extreme SUA groups (<5 mg/dL vs. >7 mg/dL) showed significant differences in renal parameters, total cholesterol concentration, and left ventricular ejection fraction (EF). Multivariate regression analysis showed that SUA >7 mg/dL (OR 1.74, 95% CI 1.32-2.30) and GFR <60 mL/min/1.73 m2 (OR 1.94, 95% CI 1.46-2.48) are significant markers of EF <40% in the study population. Female sex was a protective factor (OR 0.74, 95% CI 0.56-0.97). The cut-off point for SUA with 60% sensitivity and specificity indicative of an EF <40% was 6.9 mg/dL. Conclusions: Although rarely assessed, hyperuricemia appears to be common in patients with AF. High SUA levels may be a significant biomarker of reduced left ventricular EF in AFpatients.
Entities:
Keywords:
atrial fibrillation; heart failure; hyperuricemia; left ventricular ejection fraction
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