Association Between Serum Uric Acid Levels and Atrial Fibrillation Burden

Xiangyi Kong , Le Zhou , Jue Wang , Liu He , Shijun Xia , Chao Jiang , Yuanyuan Liu , Shaobin Wei , Jingye Li , Wenli Dai , Lan Ren , Yu Kong , Xiaoxia Liu , Song Zuo , Xueyuan Guo , Songnan Li , Chenxi Jiang , Ning Zhou , Ribo Tang , Caihua Sang , Deyong Long , Jianzeng Dong , Changsheng Ma

Cardiovascular Innovations and Applications ›› 2026, Vol. 11 ›› Issue (1) : 999

PDF (1636KB)
Cardiovascular Innovations and Applications ›› 2026, Vol. 11 ›› Issue (1) :999 DOI: 10.15212/CVIA.2025.0034
Original article
research-article
Association Between Serum Uric Acid Levels and Atrial Fibrillation Burden
Author information +
History +
PDF (1636KB)

Abstract

Objective: This study investigated the association between serum uric acid (UA) levels and atrial fibrillation (AF) burden in Chinese patients with AF. Methods: In this cross-sectional study, AF burden was defined as the proportion of AF duration to total monitoring time, recorded by a patch device over ≥24 hours. Serum UA levels were measured at the start of monitoring. Multivariate logistic regression was used to assess associations. Results: A total of 952 patients with AF (66.4% women; median age 64 years) were included. A 1-SD increase in UA (91.4 μmol/L) was associated with elevated risk of persistent AF (adjusted OR: 1.32; 95% CI: 1.12-1.55; P < 0.001). The highest UA quintile had a greater risk of persistent AF than the lowest quintile of patients (adjusted OR: 2.43; 95% CI: 1.49-3.98; P for trend < 0.001). Conclusion: Serum UA levels are positively associated with AF burden in a dose-dependent manner. UA might serve as an accessible biomarker and potential therapeutic target for AF burden assessment.

Keywords

atrial fibrillation / atrial fibrillation burden / serum uric acid, biomarker / association

Cite this article

Download citation ▾
Xiangyi Kong, Le Zhou, Jue Wang, Liu He, Shijun Xia, Chao Jiang, Yuanyuan Liu, Shaobin Wei, Jingye Li, Wenli Dai, Lan Ren, Yu Kong, Xiaoxia Liu, Song Zuo, Xueyuan Guo, Songnan Li, Chenxi Jiang, Ning Zhou, Ribo Tang, Caihua Sang, Deyong Long, Jianzeng Dong, Changsheng Ma. Association Between Serum Uric Acid Levels and Atrial Fibrillation Burden. Cardiovascular Innovations and Applications, 2026, 11 (1) : 999 DOI:10.15212/CVIA.2025.0034

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Elliott AD, Middeldorp ME, Van Gelder IC, Albert CM, Sanders P. Epidemiology and modifiable risk factors for atrial fibrillation. Nat Rev Cardiol. 2023. Vol. 20(6):404-17

[2]

Shi S, Tang Y, Zhao Q, Yan H, Yu B, Zheng Q, et al.. Prevalence and risk of atrial fibrillation in China: a nation-al cross-sectional epidemiological study. Lancet Reg Health West Pac. 2022. Vol. 23:100439

[3]

Escudero-Martínez I, Morales-Caba L, Segura T. Atrial fibrillation and stroke: a review and new insights. Trends Cardiovasc Med. 2023. Vol. 33(1):23-9

[4]

Soliman EZ, Safford MM, Muntner P, Khodneva Y, Dawood FZ, Zakai NA, et al.. Atrial fibrillation and the risk of myocardial infarction. JAMA Intern Med. 2014. Vol. 174(1):107-14

[5]

Reddy YNV, Borlaug BA, Gersh BJ. Management of atrial fibrillation across the spectrum of heart failure with preserved and reduced ejection fraction. Circulation. 2022. Vol. 146(4):339-57

[6]

Ott A, Breteler MM, de Bruyne MC, van Harskamp F, Grobbee DE, Hofman A. Atrial fibrillation and dementia in a population-based study. The Rotterdam study. Stroke. 1997. Vol. 28(2):316-21

[7]

Benn M. Atrial fibrillation and chronic kidney disease. Eur Heart J. 2021. Vol. 42(29):2824-6

[8]

Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998. Vol. 98(10):946-52

[9]

Chung MK, Eckhardt LL, Chen LY, Ahmed HM, Gopinathannair R, Joglar JA, et al.. Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association. Circulation. 2020. Vol. 141(16):e750-72

[10]

Chen LY, Chung MK, Allen LA, Ezekowitz M, Furie KL, McCabe P, et al.. Atrial fibrillation burden: moving beyond atrial fibrillation as a binary entity: a scientific statement from the American Heart Association. Circulation. 2018. Vol. 137(20):e623-44

[11]

Bortolotti M, Polito L, Battelli MG, Bolognesi A. Xanthine oxidoreductase: one enzyme for multiple physiological tasks. Redox Biol. 2021. Vol. 41:101882

[12]

Huang G, Xu RH, Xu JB, Liu Y, Liu ZH, Xie X, et al.. Hyperuricemia is associated with atrial fibrillation prevalence in very elderly -a community based study in Chengdu, China. Sci Rep. 2018. Vol. 8(1):12403

[13]

Korantzopoulos P, Letsas KP, Liu T. Xanthine oxidase and uric acid in atrial fibrillation. Front Physiol. 2012. Vol. 3:150

[14]

Zhang CH, Huang DS, Shen D, Zhang LW, Ma YJ, Wang YM, et al.. Association between serum uric acid levels and atrial fibrillation risk. Cell Physiol Biochem. 2016. Vol. 38(4):1589-95

[15]

Zhang M, Zhu X, Wu J, Huang Z, Zhao Z, Zhang X, et al.. Prevalence of hyperuricemia among Chinese adults: findings from two nationally representative cross-sectional surveys in 2015-16 and 2018-19. Front Immunol. 2022. Vol. 12:791983

[16]

Du X, Guo L, Xia S, Du J, Anderson C, Arima H, et al.. Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China. Heart. 2021. Vol. 107(7):535-41

[17]

Lioté F, Choi H. Managing gout needs more than drugs: ‘Il faut le savoir-faire, l’Art et la manière’. Ann Rheum Dis. 2013. Vol. 72(6):791-3

[18]

Andres M, Sivera F, Falzon L, van der Heijde DM, Carmona L. Treatment target and followup measures for patients with gout: a systematic literature review. J Rheumatol Suppl. 2014. Vol. 92:55-62

[19]

Ma C, Yu H, Zhang W, Fu H, Wan G, Yang G, et al.. High-normal serum uric acid predicts macrovascular events in patients with type 2 diabetes mellitus without hyperuricemia based on a 10-year cohort. Nutr Metab Cardiovasc Dis. 2023. Vol. 33(10):1989-97

[20]

Han Y, Wang S, Zhao H, Cao Y, Han X, Di H, et al.. Lower serum uric acid levels may lower the incidence of diabetic chronic complications in U.S. adults aged 40 and over. J Clin Med. 2023. Vol. 12(2):725

[21]

Cheng S, He J, Han Y, Han S, Li P, Liao H, et al.. Global burden of atrial fibrillation/atrial flutter and its attributable risk factors from 1990 to 2021. Europace. 2024. Vol. 26(7):euae195

[22]

Valbusa F, Bertolini L, Bonapace S, Zenari L, Zoppini G, Arcaro G, et al.. Relation of elevated serum uric acid levels to incidence of atrial fibrillation in patients with type 2 diabetes mellitus. Am J Cardiol. 2013. Vol. 112(4):499-504

[23]

Wang S, Wei Y, Hidru TH, Li D, Wang N, Yang Y, et al.. Combined effect of homocysteine and uric acid to identify patients with high risk for subclinical atrial fibrillation. J Am Heart Assoc. 2022. Vol. 11(1):e021997

[24]

Nyrnes A, Toft I, Njølstad I, Mathiesen EB, Wilsgaard T, Hansen JB, et al.. Uric acid is associated with future atrial fibrillation:an 11-year follow-up of 6308 men and women--the Tromso study. Europace. 2013. Vol. 16(3):320-6

[25]

Ding M, Viet NN, Gigante B, Lind V, Hammar N, Modig K. Elevated uric acid is associated with new-onset atrial fibrillation: results from the Swedish AMORIS cohort. J Am Heart Assoc. 2023. Vol. 12(3):e027089

[26]

Wang X, Hou Y, Wang X, Li Z, Wang X, Li H, et al.. Relationship between serum uric acid levels and different types of atrial fibrillation: an updated meta-analysis. Nutr Metab Cardiovasc Dis. 2021. Vol. 31(10):2756-65

[27]

Kuwabara M, Hisatome I, Niwa K, Hara S, Roncal-Jimenez CA, Bjornstad P, et al.. Uric acid is a strong risk marker for developing hypertension from prehypertension: a 5-year Japanese cohort study. Hypertension. 2018. Vol. 71(1):78-86

[28]

Loeffler LF, Navas-Acien A, Brady TM,Miller ER 3rd, Fadrowski JJ. Uric acid level and elevated blood pressure in US adolescents: National Health and Nutrition Examination Survey, 1999-2006. Hypertension. 2012. Vol. 59(4):811-7

[29]

Terawaki H, Yoshimura R, Ueda H, Tajirika S, Kawamoto M, Horita R, et al.. Elevated uric acid levels as a risk factor for new-onset hypertension in newly enrolled Japanese university students (JSH46-0100). Hypertens Res. 2024. Vol. 48:780-5

[30]

Aune D, Mahamat-Saleh Y, Kobeissi E, Feng T, Heath AK, Janszky I, et al.. Blood pressure, hypertension and the risk of atrial fibrillation: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol. 2023. Vol. 38(2):145-78

[31]

Yu W, Cheng J-D. Uric acid and cardiovascular disease: an update from molecular mechanism to clinical perspective. Front Pharmacol. 2020. Vol. 11:582680

[32]

Doehner W, Landmesser U. Xanthine oxidase and uric acid in cardiovascular disease: clinical impact and therapeutic options. Semin Nephrol. 2011. Vol. 31(5):433-40

[33]

Phillips K, Subramanian A, Thomas GN, Khan N, Chandan JS, Brady P, et al.. Trends in the pharmacological management of atrial fibrillation in UK general practice 2008-2018. Heart. 2022. Vol. 108(7):517-22

[34]

Becher N, Metzner A, Toennis T, Kirchhof P, Schnabel RB. Atrial fibrillation burden: a new outcome predictor and therapeutic target. Eur Heart J. 2024. Vol. 45(31):2824-38

[35]

Singh JA, Cleveland JD. Comp-arative effectiveness of allopurinol and febuxostat for the risk of atrial fibrillation in the elderly: a propensity-matched analysis of Medicare claims data. Eur Heart J. 2019. Vol. 40(36):3046-54

[36]

Chen L, Jiang C. Deep learning-based handheld device-enabled symptom-driven recording: a pragmatic approach for the detection of post-ablation atrial fibrillation recurrence. Cardiovasc Innov Appl. 2023. Vol. 8(1):e964

[37]

Wang Z, Zhang Y, Jiang C, Hu R, Dai W, Kong Y, Sun L, et al.. Atrial Fibrillation Follow-up Investigation to Recover Memory and Learning Trial (AFFIRMING): rationale and design of a multi-center, double-blind, randomized controlled trial. Cardiovasc Innov Appl. 2024. Vol. 9(1):e998

PDF (1636KB)

0

Accesses

0

Citation

Detail

Sections
Recommended

/