Hyperuricemia and Gout are Associated with the Risk of Atrial Fibrillation: An Updated Meta-Analysis

Background: Although it has been suggested that hyperuricemia and gout are predictive of the future risk of atrial fibrillation, there is still a lack of epidemiological evidence. Objective: Through an updated systematic review and meta-analysis, we aimed to assess the association between hyperuricemia/gout and atrial fibrillation. Methods: We performed a systematic search of EMBASE, PubMed, and Web of Science from their establishment to September 2021 for all relevant studies of hyperuricemia or gout and atrial fibrillation. Meta-analysis was conducted using the random-effects method to calculate the overall relative risk (RR) and 95% confidence intervals (CI), and subgroup analyses were performed on data subsets by geographic location and study design. Result: A total of 12 studies were included in this study. The results from 8 studies showed that hyperuricemia was associated with an increased incidence of atrial fibrillation (RR: 1.83, 95% CI: 1.35-2.47), but significant association was only observed in studies in China (RR: 1.88, 95% CI: 1.31-2.71) and cross-sectional studies (RR: 2.35, 95% CI: 1.97-2.81) rather than studies in Japan (RR: 1.74, 95% CI: 0.71-4.23) and cohort studies (RR: 1.20, 95% CI: 0.99-1.46). The results from 4 studies showed that gout was also associated with an increased risk of AF (RR: 1.33, 95% CI: 1.04-1.71). Conclusions: Hyperuricemia and gout are associated with an increased incidence of atrial fibrillation.