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Tan Y, Chen Y, Wang T, Li J. Serum uric acid and pulmonary arterial hypertension: A two-sample Mendelian randomization study. Heart Lung 2024; 68:337-341. [PMID: 39236651 DOI: 10.1016/j.hrtlng.2024.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 08/25/2024] [Accepted: 08/28/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Observational studies have suggested a correlation between hyperuricemia and pulmonary arterial hypertension (PAH), yet the causal relationship remains uncertain. We aimed to establish this link using Mendelian Randomization (MR) methods. OBJECTIVES Based on publicly accessible data, our study employs MR to determine the causal relationship between uric acid (UA) and PAH. METHOD MR analysis was conducted among individuals of European descent. Genetic instruments linked to UA (p-value < 5 × 10-8) were extracted from the Chronic Kidney Disease Genetic Consortium and genome-wide association study databases. PAH risk genetic associations were sourced separately. We employed four MR methods (MR-Egger, weighted median, inverse variance weighted, and weighted mode) with selected instrumental variables to assess the causal association between UA and PAH. MR-PRESSO was used to evaluate pleiotropy and outlier Single Nucleotide Polymorphisms (SNPs), while Cochran's Q test and funnel plot assessed SNP heterogeneity. Leave-one-out analysis examined SNP impacts on causal assessment. RESULT Two-sample MR analysis revealed a positive, causal relationship between UA levels and PAH. CONCLUSION Our MR analysis provides robust evidence of a causal link between serum UA and PAH, suggesting UA's potential as a biomarker and therapeutic target for PAH.
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Affiliation(s)
- Yingjie Tan
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yusi Chen
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tianyu Wang
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiang Li
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China.
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2
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Zhang XJ, Hou AJ, Luan B, Wang CF, Li JJ. Uric acid to albumin ratio as a novel predictor for coronary slow flow phenomenon in patients with chronic coronary syndrome and non-obstructive coronary arteries. BMC Cardiovasc Disord 2024; 24:358. [PMID: 39003493 PMCID: PMC11245809 DOI: 10.1186/s12872-024-04040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND The plasma uric acid to albumin ratio (UAR) is considered as a novel indicator for Inflammation. However, the association between UAR and coronary slow flow phenomenon (CSFP) remains unclear. METHODS A total of 1328 individuals with chronic coronary syndrome (CCS) receiving coronary angiography (CAG) and found no obvious obstructive stenosis (< 40%) were included in this study. 79 individuals developed CSFP and were divided into CSFP group. The 1:2 age-matched patients with normal coronary blood flow were allocated to the control group (n = 158). The clinical characteristics, laboratory parameters including uric acid, albumin ratio, UAR and the angiographic characteristics were compared between the two groups. RESULTS Patients with CSFP had a higher level of uric acid (392.3 ± 85.3 vs. 273.8 ± 71.5, P < 0.001), UAR (10.7 ± 2.2 vs. 7.2 ± 1.9, P < 0.001), but a lower level of plasma albumin (36.9 ± 4.2 vs. 38.5 ± 3.6, P = 0.003). Moreover, UAR increased as the numbers of vessels involved in CSFP increased. The logistic regression analysis demonstrated that UAR was independent predictors for CSFP. The Receiver operating characteristic (ROC) curve analysis showed that when UAR was more than 7.9, the AUC was 0.883 (95% CI: 0.840-0.927, p < 0.001), with the sensitivity and specificity were 78.2% and 88.2% respectively. CONCLUSION Combined uric acid with plasma albumin, UAR could serve as an independent predictor for CSFP.
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Affiliation(s)
- Xiao-Jiao Zhang
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Ai-Jie Hou
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Bo Luan
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Cheng-Fu Wang
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Jia-Jin Li
- Department of Cardiology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China.
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Zheng Y, Chen Z, Yang J, Zheng J, Shui X, Yan Y, Huang S, Liang Z, Lei W, He Y. The Role of Hyperuricemia in Cardiac Diseases: Evidence, Controversies, and Therapeutic Strategies. Biomolecules 2024; 14:753. [PMID: 39062467 PMCID: PMC11274514 DOI: 10.3390/biom14070753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/28/2024] Open
Abstract
Hyperuricemia (HUA) may lead to myocardial cell damage, thereby promoting the occurrence and adverse outcomes of heart diseases. In this review, we discuss the latest clinical research progress, and explore the impact of HUA on myocardial damage-related diseases such as myocardial infarction, arrhythmias, and heart failure. We also combined recent findings from basic research to analyze potential mechanisms linking HUA with myocardial injury. In different pathological models (such as direct action of high uric acid on myocardial cells or combined with myocardial ischemia-reperfusion model), HUA may cause damage by activating the NOD-like receptor protein 3 inflammasome-induced inflammatory response, interfering with cardiac cell energy metabolism, affecting antioxidant defense systems, and stimulating reactive oxygen species production to enhance the oxidative stress response, ultimately resulting in decreased cardiac function. Additionally, we discuss the impact of lowering uric acid intervention therapy and potential safety issues that may arise. However, as the mechanism underlying HUA-induced myocardial injury is poorly defined, further research is warranted to aid in the development novel therapeutic strategies for HUA-related cardiovascular diseases.
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Affiliation(s)
- Yue Zheng
- Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervention of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (Y.Z.); (Z.C.); (J.Y.); (Y.Y.)
- Laboratory of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Zhirui Chen
- Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervention of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (Y.Z.); (Z.C.); (J.Y.); (Y.Y.)
- Laboratory of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Jinya Yang
- Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervention of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (Y.Z.); (Z.C.); (J.Y.); (Y.Y.)
- Laboratory of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Jing Zheng
- Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI 53715, USA;
| | - Xiaorong Shui
- Laboratory of Vascular Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China;
| | - Yiguang Yan
- Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervention of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (Y.Z.); (Z.C.); (J.Y.); (Y.Y.)
- Cardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (S.H.); (Z.L.)
| | - Shian Huang
- Cardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (S.H.); (Z.L.)
| | - Zheng Liang
- Cardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (S.H.); (Z.L.)
| | - Wei Lei
- Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervention of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (Y.Z.); (Z.C.); (J.Y.); (Y.Y.)
- Laboratory of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
- Precision Medicine Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
| | - Yuan He
- Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervention of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China; (Y.Z.); (Z.C.); (J.Y.); (Y.Y.)
- Laboratory of Cardiovascular Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
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4
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Canpolat U. Editorial to "The association between hyperuricemia and atrial fibrillation recurrence after catheter ablation". J Arrhythm 2024; 40:527-528. [PMID: 38939775 PMCID: PMC11199818 DOI: 10.1002/joa3.13044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 06/29/2024] Open
Affiliation(s)
- Ugur Canpolat
- Department of Cardiology, Arrhythmia and Electrophysiology UnitHacettepe University Faculty of MedicineAnkaraTurkey
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Yuan HJ, Jiao HC, Liu XJ, Hao H, Liu Y, Xue YT, Li Y. Association of Serum Uric Acid with Non-Valvular Atrial Fibrillation: A Retrospective Study in China. Int J Gen Med 2024; 17:1533-1543. [PMID: 38680194 PMCID: PMC11048212 DOI: 10.2147/ijgm.s458089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose The association between serum uric acid (SUA) and atrial fibrillation (AF) has been widely focused on and studied in recent years. However, the exact association between SUA and AF is unclear, and the effect of gender on the association between SUA levels and AF has been controversial. This study aimed to investigate the association between SUA levels and non-valvular AF (NVAF) and the potential effect of gender on it. Patients and Methods A total of 866 NVAF patients (463 males, age 69.44 ± 8.07 years) and 646 sex-matched control patients in sinus rhythm, with no history of arrhythmia were included in this study. t-test, ANOVA, and chi-square test were used for baseline data analysis. The receiver operating characteristic curve, logistic regression and Pearson correlation analysis were used for correlation analysis. Results Compared to controls, NVAF patients exhibited higher SUA (P<0.001). After adjusting for confounders of NVAF, SUA remained significantly associated with NVAF, regardless of gender (OR= 1.31, 95% CI 1.18-1.43, P<0.001). SUA demonstrated higher predictability and sensitivity in predicting the occurrence of female NVAF compared to male (area under the curve was 0.68 (95% CI 0.64-0.72, P<0.001), sensitivity 87.3%), with the optimal cut-off point identified as 5.72 mg/dL. Furthermore, SUA levels correlated with APOA1, Scr and NT-proBNP in NVAF patients. SUA levels varied significantly among NVAF subtypes. Conclusion High SUA levels were independently associated with NVAF, regardless of gender. SUA exhibited higher predictability and sensitivity in predicting the occurrence of NVAF in females compared to males. High SUA levels may affect other NVAF-related factors and participate in the pathophysiological process of NVAF.
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Affiliation(s)
- Hua-Jing Yuan
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Hua-Chen Jiao
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Xiu-Juan Liu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Hao Hao
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Yang Liu
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Yi-Tao Xue
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Yan Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
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Baroni M, Fortuna M, Maloberti A, Leidi F, Ciampi CM, Carbonaro M, Testoni A, Vargiu S, Varrenti M, Paolucci M, Gigli L, Giannattasio C, Mazzone P. Uric acid significantly correlates with the presence of low-voltage areas at the endocardial mapping in patients with non-valvular atrial fibrillation. Nutr Metab Cardiovasc Dis 2023; 33:1323-1329. [PMID: 37248142 DOI: 10.1016/j.numecd.2023.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND AIMS Interest in the role of atrial substrate in maintaining Atrial Fibrillation (AF) is growing. Fibrosis is the culprit in the electrical derangement of the myocytes. Many cardiovascular risk factors are known to be linked to atrial scarring; among them Uric Acid (UA) is emerging. The purpose of our study is to find whether UA is associated with Left Atrium (LA) with pathological substrate. METHODS AND RESULTS 81 patients who underwent radiofrequency transcatheter ablation for nonvalvular AF at the cardiological department of the Niguarda Hospital were enrolled in an observational, cross-sectional, single-center study. UA levels were analysed before the procedure. High density electroanatomic mapping of the LA was performed and patients were divided according to the presence or not of areas of pathological substrate (bipolar voltage <0.5 mV in sinus rhythm). 19 patients showed a LA with pathological substrate. These subjects showed a significant higher prevalence of persistent phenotype of AF (84.2 vs. 25.8%, p < 0.001). UA levels were significantly higher in the group of patients with LA with pathological substrate (6.8 ± 1.9 vs 5.3 ± 1.4 mg/dL, p < 0.001) as well as the prevalence of hyperuricemia (26.5 vs. 6.5%, p = 0.021). The association between uric acid LA with pathological substrate remains significant even after correction for confounding factors (age, left ventricular dysfunction, valvular disease, arrythmia phenotype and furosemide use) and also when the ratio UA/creatinine was evaluated. CONCLUSIONS In a population of patients who underwent AF ablation, higher UA levels were significantly associated with pathological LA substrate at electro-anatomical mapping.
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Affiliation(s)
- Matteo Baroni
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Matteo Fortuna
- Department of Medicine, University of Milano-Bicocca, Milan, Italy
| | - Alessandro Maloberti
- Department of Medicine, University of Milano-Bicocca, Milan, Italy; Cardiology 4, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy.
| | - Filippo Leidi
- Department of Medicine, University of Milano-Bicocca, Milan, Italy
| | | | - Marco Carbonaro
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Alessio Testoni
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Sara Vargiu
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Marisa Varrenti
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Marco Paolucci
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Lorenzo Gigli
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Cristina Giannattasio
- Department of Medicine, University of Milano-Bicocca, Milan, Italy; Cardiology 4, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
| | - Patrizio Mazzone
- Cardiology 3, "A.De Gasperis" Cardio Center, ASST GOM Niguarda Ca' Granda, Milan, Italy
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Kuwabara M, Kodama T, Ae R, Kanbay M, Andres-Hernando A, Borghi C, Hisatome I, Lanaspa MA. Update in uric acid, hypertension, and cardiovascular diseases. Hypertens Res 2023; 46:1714-1726. [PMID: 37072573 DOI: 10.1038/s41440-023-01273-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/18/2023] [Accepted: 03/12/2023] [Indexed: 04/20/2023]
Abstract
A direct relationship between serum uric acid levels and hypertension, cardiovascular, renal and metabolic diseases has been reported in many basic and epidemiological studies. Among these, high blood pression is one of the most common features associated with hyperuricemia. In this regard, several small-scale interventional studies have demonstrated a significant reduction in blood pressure in hypertensive or prehypertensive patients on uric acid-lowering drugs. These observation or intervention studies have led to affirm that there is a causal relationship between uric acid and hypertension. While the clinical association between uric acid and high blood pressure is notable, no clear conclusion has yet been reached as to whether lowering uric acid is beneficial to prevent cardiovascular and renal metabolic diseases. Recently, several prospective randomized controlled intervention trials using allopurinol and other uric acid-lowering drugs have been reported, and the results from these trials were almost negative, suggesting that the correlation between hyperuricemia and cardiovascular disease has no causality. However, it is important to note that in some of these recent studies there were high dropout rates and an important fraction of participants were not hyperuricemic. Therefore, we should carry caution in interpreting the results of these studies. This review article presents the results of recent clinical trials using uric acid-lowering drugs, focusing on hypertension and cardiovascular and renal metabolic diseases, and discusses the future of uric acid therapy.
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Affiliation(s)
| | | | - Ryusuke Ae
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Tochigi, Japan
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ana Andres-Hernando
- Division of Endocrinology, Metabolism and Diabetes, School of Medicine, University of Colorado Denver, Aurora, CO, USA
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Ichiro Hisatome
- Department of Cardiology, Yonago Medical Center, Yonago, Torrori, Japan
| | - Miguel A Lanaspa
- Division of Endocrinology, Metabolism and Diabetes, School of Medicine, University of Colorado Denver, Aurora, CO, USA
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Zhong X, Jiao H, Zhao D, Yang M, Teng J. Association between serum uric acid levels and atrial fibrillation in different fasting glucose patterns: A case-control study. Front Endocrinol (Lausanne) 2023; 14:1021267. [PMID: 36755929 PMCID: PMC9899926 DOI: 10.3389/fendo.2023.1021267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Previous studies have shown both dysglycaemia and hyperuricemia are associated with an increased risk of atrial fibrillation (AF), while the relationship between serum uric acid (SUA) levels and AF in different fasting glucose patterns (FBG) is unclear. Therefore, this study aimed to determine the association between SUA and AF in different FBG patterns. METHODS A total of 1840 patients in this case-control study were enrolled, including 920 AF patients and 920 controls. Patients were divided into three groups according to the different FBG patterns: normoglycemic, impaired fasting glucose (IFG), and diabetes mellitus (DM). Multivariate logistic regression models were performed to evaluate the relationship between SUA and AF in different FBG patterns. Pearson correlation analysis was used to explore the correlation between SUA and metabolic factors. Receiver operating characteristic (ROC) curve models indicated the diagnostic efficiency of SUA for diagnosing AF. RESULTS SUA was independently associated with AF after adjusting for all confounding factors in different FBG patterns(normoglycemic: OR=1.313, 95% CI:1.120-1.539; IFG: OR=1.386, 95% CI:1.011-1.898; DM: OR=1.505, 95% CI:1.150-1.970). Pearson's correlation analysis suggested that SUA in AF patients was correlated with several different metabolic factors in different FBG patterns (p<0.05). ROC curve analysis showed that SUA in the normoglycemic group combined with CHD and APOB [AUC: 0.906 (95% CI: 0.888-0.923)], in the IFG group combined with CHD and Scr [AUC: 0.863 (95% CI: 0.820-0.907)], in the DM group combined with CHD and SBP [AUC: 0.858 (95% CI: 0.818-0.898)] had the highest AUC for predicting AF. CONCLUSION Findings implied a significant association between SUA and AF in different FBG patterns and provide specific models combined with other factors (CHD, APOB, SCr, SBP), which might contribute to the diagnosis of AF.
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Affiliation(s)
- Xia Zhong
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- *Correspondence: Huachen Jiao,
| | - Dongsheng Zhao
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Mengqi Yang
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jing Teng
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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Zhong X, Jiao H, Zhao D, Teng J. A case-control study to investigate association between serum uric acid levels and paroxysmal atrial fibrillation. Sci Rep 2022; 12:10380. [PMID: 35726017 PMCID: PMC9209416 DOI: 10.1038/s41598-022-14622-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/09/2022] [Indexed: 11/24/2022] Open
Abstract
The relationship between serum uric acid (SUA) levels and paroxysmal atrial fibrillation (AF) remains controversial. The objective of this case–control study was to investigate the association between serum SUA levels and paroxysmal AF by gender in 328 patients. This study included 328 hospitalized patients with newly diagnosed paroxysmal AF in China between January 2019 and September 2021. Controls with sinus rhythm were matched (2:1) to cases by age and gender. Baseline data were analyzed using ANOVA, T-test, and Chi-square test. Pearson correlation analyses were used to confirm the correlation between variables, and multivariate regression analyses were used to adjust for covariates. Elevated SUA levels in female patients were significantly associated with paroxysmal AF after adjusting for confounding factors (OR = 1.229, 95% CI 1.058–1.427, P = 0.007). Further results showed SUA levels were negatively correlated with high-density lipoprotein cholesterol (HDL-C) (r = − 0.182, p = 0.001) and apolipoprotein A1 (APOA1) (r = − 0.109, p = 0.049), were positively correlated with low-density lipoprotein cholesterol (LDL-C) (r = 0.169, p = 0.002) and prealbumin (PAB) (r = 0.161, p = 0.004) . Nevertheless, there was no significant complication difference between SUA levels and paroxysmal AF (P > 0.05). Increased SUA in female patients was significantly associated with paroxysmal AF in a Chinese population. This finding implies that it would be interesting to monitor and interfere with hyperuricemia in paroxysmal AF patients.
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Affiliation(s)
- Xia Zhong
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People's Republic of China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369, Jingshi Road, Lixia District, Jinan, Shandong, People's Republic of China.
| | - Dongsheng Zhao
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People's Republic of China
| | - Jing Teng
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People's Republic of China
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Zacks ES, Stokke IM, Wachtell K, Hille DA, Høieggen A, Kjeldsen SE, Julius S, Gerdts E, Okin PM, Devereux RB. Time-varying serum uric acid predicts new-onset atrial fibrillation in treated hypertensive patients. The LIFE Study. EXPLORATION OF MEDICINE 2022. [DOI: 10.37349/emed.2022.00079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim: The Losartan Intervention For Endpoint reduction in hypertension (LIFE) Study showed less new-onset atrial fibrillation (AF) in hypertensive patients receiving losartan- vs. atenolol-based treatment. Because losartan reduces serum uric acid (SUA) levels, the aim of the present study was to investigate relations of SUA with new-onset AF in the study.
Methods: Hypertensive patients with electrocardiographic (ECG) left ventricular hypertrophy (LVH) and no prior AF (n = 8,243) were treated for 5.0 ± 0.4 years with losartan- or atenolol-based therapy. Associations of SUA with new-onset AF documented by Minnesota coding were assessed by Cox models using SUA and systolic blood pressure as time-varying covariates to take into account changes of SUA related to losartan or diuretic treatment, changes in renal function, and aging.
Results: Time-varying SUA was associated with new AF defined by Minnesota code [hazard ratio (HR) = 1.19 per 16.8 μmol/L (1 mg/dL), (95% confidence intervals (CIs), 1.12–1.26), P < 0.0001], independent of losartan treatment [HR = 0.75 (95% CIs, 0.61–0.93), P = 0.007], older age [HR = 1.95 per 7.0 years (95% CIs, 1.73–2.20), P < 0.0001], male sex [HR = 1.46 (95% CIs, 1.09–1.94), P = 0.010] and higher Cornell voltage-duration product [HR = 1.10 per 1,023 ms·mm (95% CIs, 1.01–1.21), P = 0.034]. Similar results were obtained in Cox models with SUA levels partitioned according to baseline quartiles and in which AF was defined by physician reports or by both Minnesota coding and physician reports.
Conclusions: In-treatment SUA is a strong predictor for new-onset AF in hypertensive patients, independent of effects of antihypertensive treatment, age, sex, and ECG-LVH. Further research is needed to clarify how uric acid may provoke AF (ClinicalTrials.gov identifier: NCT00338260).
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Affiliation(s)
- Eran S. Zacks
- 1Greenberg Division of Cardiology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Ildri M. Stokke
- 2Departments of Cardiology and Nephrology, Ullevaal Hospital, University of Oslo, N-0407 Oslo, Norway
| | - Kristian Wachtell
- 1Greenberg Division of Cardiology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Darcy A. Hille
- 3Merck Research Laboratories, North Wales, PA 19454, USA
| | - Aud Høieggen
- 2Departments of Cardiology and Nephrology, Ullevaal Hospital, University of Oslo, N-0407 Oslo, Norway
| | - Sverre E. Kjeldsen
- 2Departments of Cardiology and Nephrology, Ullevaal Hospital, University of Oslo, N-0407 Oslo, Norway 4Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Stevo Julius
- 4Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Eva Gerdts
- 5Department of Clinical Science, University of Bergen, N-5020 Bergen, Norway
| | - Peter M. Okin
- 1Greenberg Division of Cardiology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Richard B. Devereux
- 1Greenberg Division of Cardiology, Weill Cornell Medicine, New York, NY 10021, USA
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