title: Serum uric acid and risk of left atrial thrombus in patients with nonvalvular atrial fibrillation.
abstract: BACKGROUND
  Serum uric acid (SUA) is a simple and independent marker of morbidity and mortality in a variety of cardiovascular diseases. In this study we aimed to investigate SUA and the risk of left atrial (LA) thrombus in patients with nonvalvular atrial fibrillation (AF).
  
  
  METHODS
  In this retrospective study, 1359 consecutive patients undergoing transesophageal echocardiography before catheter ablation of AF were enrolled. Sixty-one of the 1359 patients (4.5%) had LA thrombus.
  
  
  RESULTS
  SUA levels in patients with LA thrombus were significantly greater (413.5 ± 98.8 μmol/L vs 366.7 ± 94.3 μmol/L; P < 0.001). Hyperuricemia was defined as SUA ≥ 359.8 μmol/L in women and ≥ 445.6 μmol/L in men determined according to receiver operating characteristic curve. The incidence of LA thrombus was significantly greater in patients with hyperuricemia than in those with a normal SUA level in women (12.1% vs 1.9%; P < 0.001) and in men (8.5% vs 2.8%; P < 0.001). Hyperuricemia had a negative predictive value of 98.1% in women and 97.1% in men for identifying LA thrombus. Hyperuricemia was associated with significantly greater risk of LA thrombus among Congestive Heart Failure, Hypertension, Age ≥ 75 Years, Diabetes Mellitus, Stroke, Vascular Disease, Age 65 to 74 Years, Sex Category (CHA2DS2-VASc) score = 0, 1, and ≥ 2 groups with odds ratios of 7.19, 4.05, and 3.25, respectively. In multivariable analysis, SUA was an independent risk factor of LA thrombus (odds ratio, 1.004; 95% confidence interval, 1.000-1.008; P = 0.028).
  
  
  CONCLUSIONS
  Hyperuricemia was a modest risk factor for LA thrombus, which might refine stratification of LA thrombus in patients with nonvalvular AF.
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Ri-Bo
authors.initials: RB
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Xian-Liang
authors.initials: XL
authors.lastname: Yan
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Jun-Ping
authors.initials: JP
authors.lastname: Kang
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Jia-Hui
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Rong-Hui
authors.initials: RH
authors.lastname: Yu
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: De-Yong
authors.initials: DY
authors.lastname: Long
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Man
authors.initials: M
authors.lastname: Ning
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Cai-Hua
authors.initials: CH
authors.lastname: Sang
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Chen-Xi
authors.initials: CX
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Salim
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China. Electronic address: chshma@vip.sina.com.
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000379:methods*; D002681:China / Q000453:epidemiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013927:Thrombosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid