Chang-Fu Kuo, Matthew J. Grainge, Christian Mallen, Weiya Zhang, Michael Doherty
Affiliation(s):
Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK ; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; Arthritis Research UK Primary Care Centre, Keele University, Keele, UK.
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.