High Serum Uric Acid Associated with AF
MIAMI – What is the relationship between atrial fibrillation (AF) and high serum uric acid (SUA)?
Noting that AF is related to oxidative stress, neurohormonal activation and inflammatory activation and that SUA is a surrogate marker of oxidative stress, researchers from the Miami VAMC and colleagues performed a meta-analysis to evaluate the evidence supporting an association.
For the study published recently in the Heart Rhythm Journal, the researchers searched the MEDLINE database from 1966 to 2013, supplementing their effort with manual searches of bibliographies of key relevant articles. All cross-sectional and cohort studies in which SUA was measured and AF was reported were selected for review.1
That search strategy yielded 40 studies, of which only nine met the eligibility criteria and six cross-sectional studies involving 7,930 evaluable patients with a median prevalence of heart failure of 4% (IQR 0%-100%).
“The standardized mean difference of SUA for those with AF was 0.42 (95% CI 0.27-0.58) compared with those without AF,” the authors wrote. “The three cohort studies evaluated 138,306 individuals without AF. The relative risk of having AF for those with high SUA was 1.67 (95% CI 1.23-2.27) compared with those with normal SUA.”
Ultimately, they found that “high SUA is associated with AF in both cross-sectional and cohort studies,” but added that it remains “unclear whether SUA represents a disease marker or a treatment target.”
1Tamariz L, Hernandez F, Bush A, Palacio A, Hare JM. Association between serum uric acid and atrial fibrillation: a systematic review and meta-analysis. Heart Rhythm. 2014 Jul;11(7):1102-8. doi: 10.1016/j.hrthm.2014.04.003. Epub 2014 Apr 5. PubMed PMID: 24709288.
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