Effect of hyperuricemia on paroxysmal atrial fibrillation after catheter ablation and influence of alcohol consumption

IF 2.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Arrhythmia Pub Date : 2024-06-19 DOI:10.1002/joa3.13092

Kazuki Shimojo MD, Itsuro Morishima MD, PhD, Yasuhiro Morita MD, Yasunori Kanzaki MD, Hiroyuki Miyazawa MD, Naoki Watanabe MD, PhD, Naoki Yoshioka MD, PhD, Naoki Shibata MD, PhD, Yoshihito Arao MD, PhD, Ryota Yamauchi MD, Takuma Ohi MD, Hiroki Goto MD, Hoshito Karasawa MD, Kenji Okumura MD, PhD

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Abstract

Background

Evidence regarding the association between hyperuricemia and arrhythmia recurrence after catheter ablation for paroxysmal atrial fibrillation (AF) is scarce. We investigated whether hyperuricemia predicts arrhythmia recurrence after catheter ablation for paroxysmal AF and the relationship between hyperuricemia and alcohol consumption in AF recurrence.

Methods

Patients who underwent catheter ablation for paroxysmal AF were divided into the hyperuricemia (index serum uric acid [UA] >7.0 mg/dL; n = 114) and control (UA ≤7.0 mg/dL; n = 609) groups and were followed for a median of 24 (12–48) months after ablation.

Results

The hyperuricemia group had more patients with an alcohol intake of ≥20 g/day (33.3% vs. 22.7%, p = .017) and a lower incidence of AF-free survival (p = .019). Similarly, those with an alcohol intake of ≥20 g/day had a lower incidence of AF-free survival than other patients. Multivariate Cox regression analysis revealed the following independent predictors of AF recurrence (adjusted hazard ratio, 95% confidence interval): hyperuricemia (1.64, 1.12–2.40), female gender (1.91, 1.36–2.67), brain natriuretic peptide level >100 pg/mL (1.59, 1.14–2.22), and alcohol consumption ≥20 g/day (1.49, 1.03–2.15) (all p < .05). In addition, causal mediation analysis revealed that alcohol consumption of ≥20 g/day directly affected AF recurrence, independent of hyperuricemia.

Conclusions

Patients with hyperuricemia may be at a high risk of arrhythmia recurrence after catheter ablation for paroxysmal AF. Although high alcohol consumption may contribute to increased UA levels, the presence of hyperuricemia may independently predict AF recurrence.

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高尿酸血症对导管消融术后阵发性心房颤动的影响以及饮酒的影响。

背景：有关高尿酸血症与阵发性心房颤动（房颤）导管消融术后心律失常复发之间关系的证据很少。我们研究了高尿酸血症是否可预测阵发性房颤导管消融术后的心律失常复发，以及高尿酸血症和饮酒在房颤复发中的关系：方法：将接受阵发性房颤导管消融术的患者分为高尿酸血症组（血清尿酸指数[UA] >7.0 mg/dL；n = 114）和对照组（UA ≤7.0 mg/dL；n = 609），并在消融术后随访中位数24（12-48）个月：结果：高尿酸血症组中酒精摄入量≥20 克/天的患者较多（33.3% vs. 22.7%，p = .017），无房颤生存率较低（p = .019）。同样，酒精摄入量≥20 克/天的患者无房颤生存率也低于其他患者。多变量 Cox 回归分析显示了以下房颤复发的独立预测因素（调整后危险比，95% 置信区间）：高尿酸血症（1.64，1.12-2.40）、女性性别（1.91，1.36-2.67）、脑钠肽水平 >100 pg/mL（1.59，1.14-2.22）和酒精摄入量≥20 克/天（1.49，1.03-2.15）（均为 p 结论：高尿酸血症患者可能是阵发性房颤导管消融术后心律失常复发的高危人群。虽然大量饮酒可能会导致尿酸水平升高，但高尿酸血症的存在可单独预测房颤复发。

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