The association between serum uric acid (SUA) levels and atrial fibrillation (AF) iscurrently poorly known. We examined the association between SUA levels and risk ofincident AF in patients with type 2 diabetes mellitus. We followed for 10 years a randomsample of 400 type 2 diabetic outpatients, who were free from AF at baseline. A standard12-lead electrocardiography was undertaken annually and a diagnosis of incident AF wasconfirmed in affected participants by a single cardiologist. Over 10 years, there were42 incident AF cases (cumulative incidence of 10.5%). Elevated SUA level was associatedwith an increased risk of incident AF (odds ratio 2.43, 95% confidence interval 1.8 to 3.4,p <0.0001 for each 1-SD increase in SUA level). Adjustments for age, gender, body massindex, hypertension, chronic kidney disease, electrocardiographic features (left ventricularhypertrophy and PR interval), and use of diuretics and allopurinol did not attenuate theassociation between SUA and incident AF (adjusted odds ratio 2.44, 95% confidenceinterval 1.6 to 3.9, p <0.0001). Further adjustment for variables that were included in the10-year Framingham Heart Studyederived AF risk score did not appreciably weaken thisassociation. Results remained unchanged even when SUA was modeled as a categoricalvariable (stratifying by either SUA median or hyperuricemia), and when patients withprevious coronary heart disease or heart failure were excluded from analysis. In conclusion,our findings suggest that elevated SUA levels are strongly associated with an increased incidence of AF in patients with type 2 diabetes mellitus even after adjustment for multiple clinical risk factors for AF.

Relation of elevated serum uric acid levels to incidence of atrial fibrillation in patients with type 2 diabetes mellitus.

ZOPPINI, Giacomo;TARGHER, Giovanni
2013

Abstract

The association between serum uric acid (SUA) levels and atrial fibrillation (AF) iscurrently poorly known. We examined the association between SUA levels and risk ofincident AF in patients with type 2 diabetes mellitus. We followed for 10 years a randomsample of 400 type 2 diabetic outpatients, who were free from AF at baseline. A standard12-lead electrocardiography was undertaken annually and a diagnosis of incident AF wasconfirmed in affected participants by a single cardiologist. Over 10 years, there were42 incident AF cases (cumulative incidence of 10.5%). Elevated SUA level was associatedwith an increased risk of incident AF (odds ratio 2.43, 95% confidence interval 1.8 to 3.4,p <0.0001 for each 1-SD increase in SUA level). Adjustments for age, gender, body massindex, hypertension, chronic kidney disease, electrocardiographic features (left ventricularhypertrophy and PR interval), and use of diuretics and allopurinol did not attenuate theassociation between SUA and incident AF (adjusted odds ratio 2.44, 95% confidenceinterval 1.6 to 3.9, p <0.0001). Further adjustment for variables that were included in the10-year Framingham Heart Studyederived AF risk score did not appreciably weaken thisassociation. Results remained unchanged even when SUA was modeled as a categoricalvariable (stratifying by either SUA median or hyperuricemia), and when patients withprevious coronary heart disease or heart failure were excluded from analysis. In conclusion,our findings suggest that elevated SUA levels are strongly associated with an increased incidence of AF in patients with type 2 diabetes mellitus even after adjustment for multiple clinical risk factors for AF.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11562/608954
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