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    Impact of gout on the risk of atrial fibrillation

    Objectives: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Recent evidence suggests that uric acid participates in atrial remodelling and may lead to a higher risk of AF. However, the association between gout and AF has not been assessed. Methods. 45,378 incident gout patients and 45,378 age-, sex-, practice-, registration year- and index year-matched controls were identified from the UK Clinical Practice Research Data-link. Index dates were initial diagnosis date for gout patients and their matched controls. The risk of AF at diagnosis (odds ratios [ORs], using conditional logistic regression) and after the diagnosis of gout (hazard ratios [HRs], using Cox proportional models) were estimated, adjusted for body mass index, smoking, alcohol consumption, ischaemic heart disease, heart failure, heart valve disease, hyperthyroidism and other comorbidities and medications.

    Results. The prevalence of AF at index date in gout patients (male, 72.25%; mean age, 62.4 ± 15.1 years) was 7.42% (95% confidence interval [CI], 7.18%–7.66%) and in matched controls 2.83% (95% CI, 2.67%–2.98%). The adjusted OR (95% CI) was 1.45 (1.29–1.62). The cumulative probability of AF at 1, 2, 5 and 10 years after index date was 1.08%, 2.03%, 4.77% and 9.68% in gout patients and 0.43%, 1.08%, 2.95% and 6.33% in controls (log-rank test, p < 0.001). The adjusted HRs (95% CIs) was 1.09 (1.03–1.16).

    Conclusions. This population-based study indicates that gout is independently associated with a higher risk of AF at diagnosis and the risk is also higher after the diagnosis. Funding: University of Nottingham, National Science Council Taiwan and Chang Gung Memorial Hospital.