ISSN 2996-8215
International Journal of Cardiology | Vol. 8, No. 12, December 2017 | pp. 89–96
DOI: 10.46882/2017/IJC/000105
Original Research Article
Independent Association Between Baseline Hyperuricemia and New-Onset Atrial Fibrillation in Hypertension
Dimitris Papadopoulos¹, Nikolaos Georgiadis¹, Andreas Angelopoulos²
¹Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece
²Division of Cardiovascular Diseases, AHEPA University Hospital, Thessaloniki, Greece
Abstract:
Hypertension is a major independent risk factor for atrial fibrillation (AF), which significantly drives cardioembolic stroke risk. Serum uric acid (SUA) is a marker of oxidative stress and tissue inflammation, but its independent link to new-onset AF in hypertensive patients remains controversial. This prospective cohort study investigated whether baseline SUA levels predict the long-term incidence of new-onset AF in an unselected hypertensive population. We followed 420 hypertensive individuals in sinus rhythm with no previous history of arrhythmia. Standard metabolic panels, including SUA, were measured at enrollment. New-onset AF was documented using serial electrocardiograms and 24-hour Holter monitoring performed during annual follow-up visits or symptomatic episodes. Hyperuricemia was defined as SUA greater than 7.0 mg/dL in men and greater than 6.0 mg/dL in women. Over a median follow-up of 4.8 years, new-onset AF developed in 46 patients (11.0%). The incidence of AF was significantly higher in patients with baseline hyperuricemia compared with those with normal SUA levels (18.4% vs. 7.1%, p < 0.001). After adjusting for age, body mass index, left atrial diameter, left ventricular mass index, eGFR, and antihypertensive medication use, multivariable Cox proportional hazards analysis confirmed that elevated SUA was an independent predictor of new-onset AF (hazard ratio per 1.0 mg/dL increase: 1.26, 95% CI: 1.10–1.44, p = 0.001). Serum uric acid is independently associated with an increased risk of new-onset atrial fibrillation in hypertensive patients, representing a simple, cost-effective biomarker for refined arrhythmic risk stratification.
Keywords: Hypertension, Atrial fibrillation, Uric acid, Hyperuricemia, Oxidative stress, Biomarkers
Received: September 10, 2012; Revised: October 20, 2012; Accepted: November 11, 2012; Published: December 22, 2012