Association of Hyperuricemia with Impaired Left Ventricular Systolic Function in Patients with Atrial Fibrillation and Preserved Kidney Function: Analysis of the POL-AF Registry Cohort

Marcin Wełnicki, Iwona Gorczyca-Głowacka, Arkadiusz Lubas, Wiktor Wójcik, Olga Jelonek, Małgorzata Maciorowska, Beata Uziębło-Życzkowska, Maciej Wójcik, Robert Błaszczyk, Renata Rajtar-Salwa, Tomasz Tokarek, Jacek Bil, Michał Wojewódzki, Anna Szpotowicz, Małgorzata Krzciuk, Monika Gawałko, Agnieszka Kapłon-Cieślicka, Anna Tomaszuk-Kazberuk, Anna Szyszkowska, Janusz Bednarski, Elwira Bakuła-Ostalska, Beata Wożakowska-Kapłon and Artur Mamcarz
Additional contact information
Marcin Wełnicki: 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
Iwona Gorczyca-Głowacka: 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Jan Kochanowski University, Collegium Medicum, 25-369 Kielce, Poland
Arkadiusz Lubas: Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, 04-141 Warsaw, Poland
Wiktor Wójcik: 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
Olga Jelonek: 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Jan Kochanowski University, Collegium Medicum, 25-369 Kielce, Poland
Małgorzata Maciorowska: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Beata Uziębło-Życzkowska: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Maciej Wójcik: Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland
Robert Błaszczyk: Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland
Renata Rajtar-Salwa: Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
Tomasz Tokarek: Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
Jacek Bil: Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland
Michał Wojewódzki: Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland
Anna Szpotowicz: Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland
Małgorzata Krzciuk: Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland
Monika Gawałko: 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
Agnieszka Kapłon-Cieślicka: 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
Anna Tomaszuk-Kazberuk: Department of Cardiology, Medical University, 15-276 Bialystok, Poland
Anna Szyszkowska: Department of Cardiology, Medical University, 15-276 Bialystok, Poland
Janusz Bednarski: Department of Cardiology, St John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland
Elwira Bakuła-Ostalska: Department of Cardiology, St John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland
Beata Wożakowska-Kapłon: 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Jan Kochanowski University, Collegium Medicum, 25-369 Kielce, Poland
Artur Mamcarz: 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 12, 1-15

Abstract: Hyperuricemia is associated with the risk of developing atrial fibrillation (AF) and heart failure. However, coexisting chronic kidney disease and certain cardiovascular drugs make it difficult to determine whether hyperuricemia is a risk factor or merely a marker of pathology. We retrieved data from the Polish Atrial Fibrillation (POL-AF) registry, which included consecutive patients hospitalized with AF from January to December, 2019. We included 829 patients (mean age: 72.7 ± 11.1 years) with data on serum uric acid (UA, mean: 6.56 ± 1.78 mg/dL) and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m 2 . We found that UA and ejection fraction (EF) were significantly correlated (r = −0.15, p < 0.05), but not EF and eGFR or eGFR and UA. A multiple regression analysis adjusted for age, body mass index, eGFR, and UA, showed that UA was significantly associated with a reduced EF (R 2 : 0.021; p < 0.001). The UA cut-off indicative of an EF < 40% was 6.69 mg/dL (AUC, area under the curve: 0.607; 95% CI: 0.554–0.660; p = 0.001). Among drugs known to effect UA concentrations, we found that only diuretics were used more frequently in patients with high UA (above the median) than in patients with low UA (77.5% vs. 67%, p < 0.001). Among patients that used diuretics, UA remained significantly correlated with EF. Thus, we showed that reduced EF was associated with UA in patients with AF and normal renal function, independent of eGFR and diuretic use.

Keywords: atrial fibrillation; hyperuricemia; diuretics; renal function; left ventricular ejection fraction (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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