Increased risk of atrial fibrillation in young adults with gout: a nationwide cohort study

Background Gout is a systemic inflammatory disorder increasingly associated with cardiovascular comorbidities. However, its potential relationship with atrial fibrillation (AF), especially in young adults, has not been fully delineated. To investigate the association between gout and incident AF in a large nationwide cohort of Korean adults aged 20–39 years. Methods This retrospective cohort study analyzed 6,506,721 individuals from the Korean National Health Insurance Service (NHIS) database. Gout and AF were identified using ICD-10 codes M10 and I48, respectively. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident AF after adjusting for demographic, lifestyle, and clinical factors. Results During a median follow-up of 12.59 years, gout was associated with a significantly increased risk of AF (fully adjusted HR, 1.44; 95% CI, 1.31–1.58). The cumulative incidence of AF was significantly higher in the gout group (log-rank P < .001). Subgroup analyses demonstrated stronger associations among non-obese individuals and those with chronic kidney disease (CKD). Conclusions Gout was associated with an increased risk of atrial fibrillation among young adults. These findings suggest that gout may serve as a clinically relevant risk marker for AF, underscoring the need for proactive cardiovascular risk assessment in this population.