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Published on: February 26, 2013
Impact of gout on the risk of atrial fibrillation
Chang-Fu Kuo1, Matthew J Grainge2, Christian Mallen3
1Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK, Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Insights
Gout patients have a significantly higher risk of developing atrial fibrillation (AF) both at the time of diagnosis and in the years following. This study highlights an independent association between gout and increased AF incidence.
Area of Science:
- Cardiology
- Rheumatology
- Epidemiology
Background:
- Gout is a common inflammatory arthritis characterized by hyperuricemia.
- Atrial fibrillation (AF) is a prevalent cardiac arrhythmia with significant morbidity.
- The relationship between gout and AF requires further investigation.
Purpose of the Study:
- To assess the risk of AF at the initial diagnosis of gout.
- To evaluate the subsequent risk of AF in individuals diagnosed with gout compared to controls.
Main Methods:
- A population-based study using the UK Clinical Practice Research Data-link.
- 45,378 incident gout patients and matched controls were identified.
- Conditional logistic regression and Cox proportional models were used to estimate AF risk, adjusting for multiple covariates.
Main Results:
- Prevalence of AF at diagnosis was 7.42% in gout patients vs. 2.83% in controls (OR 1.45).
- The adjusted hazard ratio for AF after diagnosis was 1.09.
- Cumulative AF probability at 10 years was 9.68% in gout patients vs. 6.33% in controls.
Conclusions:
- Gout is independently associated with an increased risk of AF at diagnosis.
- Individuals with gout face a persistently higher risk of developing AF after diagnosis.
Objectives:
To examine the risk of atrial fibrillation (AF) at the time of first diagnosis of gout compared with matched controls and to follow incident gout patients and their matched controls after diagnosis to compare their subsequent risk of AF.
Methods:
From the UK Clinical Practice Research Data-link, 45 378 incident gout patients and 45 378 age-, sex-, practice-, registration year- and index year-matched controls were identified. 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 BMI, 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, 72.3%; mean age, 62.4 ± 15.1 years) was 7.42% (95% 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, respectively (log-rank test, P < 0.001). The adjusted HR (95% CIs) was 1.09 (1.03, 1.16).
Conclusion:
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.
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