Key result
Higher serum uric acid levels independently predicted transesophageal echocardiographic thromboembolic risk in patients with nonvalvular atrial fibrillation at low-intermediate clinical risk (OR 1.45).
Why the study?
Is serum uric acid level associated with transesophageal echocardiographic thromboembolic risk in patients with nonvalvular atrial fibrillation at clinically low-intermediate risk?
Observational (n=470)
No
Is serum uric acid level associated with transesophageal echocardiographic thromboembolic risk in patients with nonvalvular atrial fibrillation at clinically low-intermediate risk?
Odds Ratio: 1.45 (95% CI 1.09–2)
p-value: p=0.016
Elevated serum uric acid levels are independently associated with increased thromboembolic risk markers on TEE in patients with nonvalvular AF at low-intermediate clinical risk.
Should not yet change AF risk stratification; leaves open prospective validation of uric acid for thromboembolic prediction.
BACKGROUND: There is no clear consensus on thromboprophylaxis in patients with nonvalvular atrial fibrillation (AF) at low-intermediate thromboembolic risk. Although hyperuricemia is a risk factor for cardiovascular diseases, the relationship between serum uric acid (UA) levels and thromboembolic risk has not been fully elucidated in patients with AF. METHODS AND RESULTS: Serum UA levels and the score for congestive heart failure, hypertension, age, diabetes mellitus, prior stroke/transient ischemic attack, vascular disease and sex (ie, CHA2DS2-VASc score) were determined in 470 patients with nonvalvular AF who underwent transesophageal echocardiography (TEE) to evaluate their risk of thromboembolism. Serum UA levels were similar between the low-intermediate risk (CHA2DS2-VASc score=0 or 1) and high-risk (≥2) groups, although serum D-dimer levels were lower in the low-intermediate risk than in the high-risk group. Among patients at low-intermediate risk, serum UA levels were higher in those with TEE thromboembolic risk (TEE risk: low left atrial appendage flow, spontaneous echo contrast, thrombi, or aortic atherosclerosis) than in those without TEE risk. On multivariate analysis, the serum UA level was an independent predictor of TEE risk in AF patients at low-intermediate risk (odds ratio, 1.45; 95% confidence interval 1.09-2.00; P=0.016). CONCLUSIONS: The serum UA level was associated with thromboembolic risk on TEE in patients with nonvalvular AF at low-intermediate risk stratified by clinical risk factors.
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Numa et al. (2014) conducted an observational in Nonvalvular atrial fibrillation (n=470). Serum uric acid level vs. Lower serum uric acid levels was evaluated on Transesophageal echocardiographic (TEE) thromboembolic risk in patients at low-intermediate clinical risk (CHA2DS2-VASc score 0 or 1) (OR 1.45, 95% CI 1.09-2.00, p=0.016). Higher serum uric acid levels independently predicted transesophageal echocardiographic thromboembolic risk in patients with nonvalvular atrial fibrillation at low-intermediate clinical risk (OR 1.45).
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