title: The association between hyperuricemia, left atrial size and new-onset atrial fibrillation.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taiwan.
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.forename: Su-Jung
authors.initials: SJ
authors.lastname: Chen
authors.forename: Kang-Ling
authors.initials: KL
authors.lastname: Wang
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography; D014527:Uric Acid / Q000097:blood
chemical_list: D015415:Biomarkers; D014527:Uric Acid
keywords: Atrial fibrillation; Hyperuricemia; Left atrium; Uric acid