Open AccessCohort Study of Repeated Measurements of Serum Urate and Risk of Incident Atrial Fibrillation
Author(s) -
Li Shanshan,
Cheng Jin,
Cui Liufu,
Gurol M. Edip,
Bhatt Deepak L.,
Fonarow Gregg C.,
Benjamin Emelia J.,
Xing Aijun,
Xia YunLong,
Wu Shouling,
Gao Xiang
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.012020
Subject(s) - medicine , hazard ratio , gout , atrial fibrillation , proportional hazards model , c reactive protein , prospective cohort study , uric acid , gastroenterology , cohort , risk factor , hyperuricemia , cohort study , inflammation , cardiology , endocrinology , confidence interval
Background Current evidence on the association between serum urate and risk of atrial fibrillation ( AF ) is limited by cross‐sectional designs and 1‐time measurement of serum urate. The roles of serum urate, gout‐related inflammation, and systemic inflammation in the etiology of AF are currently unknown. This gap is important, given that systemic inflammation is a recognized risk factor for AF . Methods and Results We conducted a prospective cohort study of 123 238 Chinese patients from 2006 to 2014. Serum urate concentrations were measured in 2006, 2008, 2010, and 2012. Incident AF cases were identified via biennial 12‐lead ECG assessment. We used a Cox proportional hazards model to examine the sex‐specific associations of cumulative average serum urate and changes in serum urate accounting for baseline level with risk of incident AF . We also assessed the joint associations of serum urate and high‐sensitivity C‐reactive protein levels. Comparing extreme categories, participants with the highest quintile of serum urate had 1.91‐fold higher risk of AF (adjusted hazard ratio: 1.91; 95% CI, 1.32–2.76; P =0.001 for trend). Participants with both high serum urate and high‐sensitivity C‐reactive protein had 2.6‐fold elevated risk of incident AF compared with those with normal levels of serum urate and high‐sensitivity C‐reactive protein (adjusted hazard ratio: 2.63; 95% CI, 1.63–4.23). Conclusions High serum urate levels and increases in serum urate over time were associated with increased risk of incident AF . Patients with high levels of both serum urate and high‐sensitivity C‐reactive protein had substantially higher risk of AF .