The Association Between Hyperuricemia, Left Atrial Size and New-onset Atrial Fibrillation

Background: Although hyperuricemia was associated with several cardiovascular diseases, the role of uric acid (UA) in left atrial (LA) remodeling and new-onset atrial fibrillation (AF) has not been fully explored. The goal of the present study is to investigate the relationship between UA, LA diameter and the development of AF in the large-scale cohort.

Methods: The study consisted of 2 parts. First, we investigated the association between serum UA and LA diameter in a single-center database (n = 3043). Second, we studied and compared the risk of new-onset AF among patients with and without hyperuricemia in the nationwide longitudinal cohort in Taiwan (n = 122,524).

Results: Elevated serum level of UA was associated with an increased systemic inflammation, and insulin resistance. The LA diameter was significantly correlated with serum UA (r = 0.341, p value < 0.001). The linear correlation between LA dimension and UA level remained significant after the adjustment for clinical, biochemical and echocardiographic variables. In the nationwide cohort, there were 2339 patients (1.9% of the study population) developing AF during the follow-up of 6.3 ± 3.0 years. The AF occurrence rate was higher in patients with hyperuricemia than those without it (2.1% versus 1.7%; p value < 0.001). Hyperuricemia was a significant risk factor of new-onset AF with a hazard ratio of 1.191 (95% confidence interval = 1.098-1.292, p value < 0.001) in the multivariate Cox regression analysis.

Conclusions: Hyperuricemia was associated with a larger LA size and may be a novel risk factor for the development of AF.