Serum uric acid levels correlate with atrial fibrillation in patients with chronic systolic heart failure.
BACKGROUND
Studies have shown that increased levels of serum uric acid (SUA) are associated with atrial fibrillation (AF). However, less is known about the prognostic value of SUA levels for AF in patients with chronic heart failure (CHF). The aim of the study was to examine the prognostic value of SUA levels for AF in patients with CHF.


METHODS
Sixteen thousand six hundred and eighty-one patients diagnosed with CHF from 12 hospitals were analyzed. Patients were categorized into AF group and non-AF group, death group, and survival group according to the results of the patients' medical records and follow-up. Univariate and multivariate Cox proportional hazards analyses were performed to examine the risk of AF. The sensitivity and specificity of SUA level in predicting the prognosis were examined by multivariate Cox models and receiver operating characteristic (ROC) curves.


RESULTS
The results of univariate predictors in overall patients showed that the higher SUA level was associated with AF. SUA level (HR, 1.084; 95%CI, 1.017 - 1.144; P < 0.001), diuretics (HR, 1.549; 95%CI, 1.246 - 1.854; P < 0.001), and New York Heart Association (NYHA) (HR, 1.237; 95%CI, 1.168 - 1.306; P < 0.001) function class were the independent risk factors for AF. The sensitivity and specificity of the models were 29.6% and 83.8% respectively for predicting AF. When SUA level was added to these models, it remained significant (Wald c(2), 1494.88; P < 0.001 for AF); 58.8% (95%CI, 57.7% - 60.0%) of the observed results were concordant with the separate model.


CONCLUSIONS
Higher SUA level is associated strongly with AF in patients with CHF. SUA level can increase the sensitivity and specificity in predicting AF.
Cardiovascular Research Institute of Wuhan University, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
Qing-Yan
QY
Zhao
Sheng-Bo
SB
Yu
He
H
Huang
Hong-Ying
HY
Cui
Mu
M
Qin
Ting
T
Huang
Cong-Xin
CX
Huang
D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood*; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid