Predictive effect of hyperuricemia on left atrial stasis in non-valvular atrial fibrillation patients. (1st May 2018)

• Record Type: Journal Article
• Authors: Liu, Fang-Zhou; Liao, Hong-Tao; Lin, Wei-Dong; Xue, Yu-Mei; Zhan, Xian-Zhang; Fang, Xian-Hong; Rao, Fang; Deng, Hai; Huang, Jun; Hai, Jo-jo; Tse, Hung-fat; Wu, Shu-Lin
• Is Part Of: International journal of cardiology. Volume 258(2018)
• Page Start: 103
• Page End: 108
• Publication Date: 2018-05-01
• Subjects: Atrial fibrillation -- Hyperuricemia -- Left atrial thrombus -- Spontaneous echo contrast -- Thromboembolic event; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.01.080
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Objectives: To investigate the relationship between hyperuricemia and left atrial thrombus (LAT)/spontaneous echo contrast (SEC) and to determine the predictive value of hyperuricemia in non-valvular (NV) atrial fibrillation (AF) patients. Methods: The study retrospectively reviewed 1198 consecutive patients (male 801, female 397, and mean age of 56.84 ± 12.22) who were diagnosed with AF and accepted transesophageal echocardiography (TEE) prior to catheter ablation, appendage occlusion and electrical cardioversion using a single-center database. The clinical baseline characteristics were collected from medical record review and analyzed. Patients were categorized into an LAT/SEC group and a normal group. Results: According to the TEE examination, there were 97 (8.1%) patients with abnormality; of these, 49 were with LAT and 48 with SEC. The mean serum uric acid (SUA) level and hyperuricemia proportion were markedly higher in patients with LAT/SEC. The significant predictive effect was observed in the SUA level (OR = 1.006) and hyperuricemia (OR = 2.04). After adjustment for persistent/permanent-AF, age, gender, LA dimension > 40 mm, previous stroke, hypertension and diabetes, the SUA level (OR = 1.004) and hyperuricemia (OR = 1.69) were independent predictors for LAT/SEC. The SUA level (OR = 1.004) and hyperuricemia (OR = 1.69) were independent predictors for LAT/SEC, Further subgroup analysis in different CHA2 DS2 -VASc categories, it might be helpful to refine the LAT/SEC risk via combination area CHA2 DS2 -VASc score and hyperuricemia, especially in those with CHA2 DS2 -VASc score < 2. Conclusions: The SUA level and hyperuricemia proportion are closely associated with LA stasis. Hyperuricemia might independently predict and refine LA stasis risk among NVAF patients, especially in those with CHA2 DS2 -VASc score < 2. Highlights: Patients with left atrial stasis had significantly higher serum uric acid levels and hyperuricemia proportion than those normal; Hyperuricemia was an independent predictor for left atrial stasis in AF patients; Hyperuricemia had potentially reclassified ability for left atrial stasis in patients with CHA2 DS2 -VASc < 2.