Serum uric acid and incident atrial fibrillation: A systematic review and dose–response meta‐analysis

Abstract

Atrial fibrillation is the most common cardiac arrhythmia in clinical practice, with increased cardiovascular morbidity and mortality worldwide. 1 Although multiple risk factors, including cardiovascular and non-cardiovascular risk factors have been identified, the pathophysiology of atrial fibrillation remains incompletely understood. Over 40% of the risk attributed to atrial fibrillation still remains unexplained after accounting for established risk factors. Serum uric acid (SUA) is an end product of purine derivatives in metabolism in humans. 2 A high level of SUA is associated with the deposition of UA in joints and surrounding tissues. As we know, the elevated level of SUA is a contributing factor to the pathogenesis of gout, arthritis, and chronic nephropathy. Over the past two decades years, hyperuricaemia has been also widely linked to so-called "cardio-metabolic diseases", including cardiovascular diseases and type 2 diabetes. 2,3 Moreover, in recent years, several cross-sectional studies and prospective studies have shown that a high SUA

Hyperuricemia as a Marker of Reduced Left Ventricular Ejection Fraction in Patients with Atrial Fibrillation: Results of the POL-AF Registry Study

“…The results of Tamariz et al and Zhang et al are consistent in principle with the meta-analysis by Xu et al [ 18 ]. The latest research results based on the analysis of 11 studies (over 500,000 patients in total and nearly 7000 cases of AF) showed that the relationship between SUA concentration and the risk of AF is linear, that the risk increases significantly even at SUA concentrations above 5 mg/dL, and that for every additional 1 mg/dL it increases by 21% (RR 1.21; 95% CI 1.12–1.32; I2 = 78%) [ 19 ].…”

The Key Role of Uric Acid in Oxidative Stress, Inflammation, Fibrosis, Apoptosis, and Immunity in the Pathogenesis of Atrial Fibrillation

“…Recently, increased focus has been given to the possible mechanism by which hyperuricemia causes AF. Similarly, the link between hyperuricemia and other conditions such as hypertension, metabolic syndrome, diabetes mellitus, and chronic kidney disease has been reported (9)(10)(11). Uric acid [UA; 7,9-hihydro-1H-purine-2,6,8(3H)-trione; C5H4N4O3; molecular weight of 168.11 Da] is a heterocyclic organic compound and an end product of purine metabolism in humans.…”

Role of New Potential Biomarkers in the Risk of Thromboembolism in Atrial Fibrillation

“…Hyperuricemia can increase the risk of AF [39]. Numa et al [40] described that the serum uric acid level was associated with thromboembolic risk on transesophageal echocardiography in patients with NVAF at low-intermediate risk according to stratification by clinical risk factors.…”