Gout Means Greater Risk for Atrial Fibrillation

SEPTEMBER 08, 2015
Jeannette Y. Wick, RPh, MBA, FASCP
Gout patients may be at greater risk for atrial fibrillation.

Inappropriate xanthine oxidase activity and uric acid levels are central to both gout and atrial fibrillation development. Colchicine (Colcrys) is a time-tested agent for gout and has accumulated research on its role in secondary prevention of cardiovascular disease.

Researchers from Brigham and Women’s Hospital recently published a study in the Annals of the Rheumatic Diseases supporting the link between gout and incident atrial fibrillation.
 
Patients enrolled were United Healthcare clients older than 40 with at least 2 physician visits billed through specific ICD-9 codes and at least 1 dispensing for gout or osteoarthritis medications.

Those excluded from the study had been previously diagnosed with an arrhythmia, had a cardiac surgery history, were on anti-arrhythmics or anticoagulants in the 365 days prior to inclusion, or resided in a nursing home.
 
Over a mean 2-year follow-up, the incidence rate of atrial fibrillation per 1000 person-years was 7.19 in the gout group and 5.87 in the osteoarthritis population.

This increased incidence in gout compared with osteoarthritis disproves the hypothesis that atrial fibrillation is more likely to be identified in patients with a chronic condition (observation bias).
Because osteoarthritis creates minimal systemic inflammation, patients with osteoarthritis were a suitable control group for this study.

Gout appeared to increase the risk of incident atrial fibrillation even when controlling for common risk factors of cardiovascular disease (e.g. obesity) and observation bias.

This study supports the hypothesis that hyperuricemia increases atrial fibrillation incidence. However, further study is warranted to clarify the relationship between the relative level of uric acid and atrial fibrillation.

The authors invited researchers to inspect the efficacy of treating gout, controlling systemic inflammation, and lowering uric acid to decrease atrial fibrillation incidence.


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