Impact of gout on the risk of atrial fibrillation

Kuo, Chang-Fu; Grainge, Matthew J.; Mallen, Christian; Zhang, Weiya; Doherty, Michael

Abstract

OBJECTIVES: To examine the risk of atrial fibrillation (AF) at the time of first diagnosis of gout compared with matched controls and to follow incident gout patients and their matched controls after diagnosis to compare their subsequent risk of AF.

METHODS: From the UK Clinical Practice Research Data-link, 45 378 incident gout patients and 45 378 age-, sex-, practice-, registration year- and index year-matched controls were identified. Index dates were initial diagnosis date for gout patients and their matched controls. The risk of AF at diagnosis [odds ratios (ORs), using conditional logistic regression] and after the diagnosis of gout [hazard ratios (HRs), using Cox proportional models] were estimated, adjusted for BMI, smoking, alcohol consumption, ischaemic heart disease, heart failure, heart valve disease, hyperthyroidism and other comorbidities and medications.

RESULTS: The prevalence of AF at index date in gout patients (male, 72.3%; mean age, 62.4 +/- 15.1 years) was 7.42% (95% CI 7.18, 7.66%) and in matched controls 2.83% (95% CI 2.67, 2.98%). The adjusted OR (95% CI) was 1.45 (1.29, 1.62). The cumulative probability of AF at 1, 2, 5 and 10 years after index date was 1.08, 2.03, 4.77 and 9.68% in gout patients and 0.43, 1.08, 2.95 and 6.33% in controls, respectively (log-rank test, P < 0.001). The adjusted HR (95% CIs) was 1.09 (1.03, 1.16).

CONCLUSION: This population-based study indicates that gout is independently associated with a higher risk of AF at diagnosis and the risk is also higher after the diagnosis.

Citation

Kuo, C., Grainge, M. J., Mallen, C., Zhang, W., & Doherty, M. (2016). Impact of gout on the risk of atrial fibrillation. Rheumatology, 55(4), 721-728. https://doi.org/10.1093/rheumatology/kev418

• Journal Article Type: Article
• Acceptance Date: Nov 10, 2015
• Online Publication Date: Dec 17, 2015
• Publication Date: Apr 1, 2016
• Deposit Date: Feb 8, 2017
• Publicly Available Date: Feb 8, 2017
• Journal: Rheumatology
• Electronic ISSN: 1462-0324
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 55
• Issue: 4
• Pages: 721-728
• DOI: https://doi.org/10.1093/rheumatology/kev418
• Keywords: gout, atrial fibrillation, relative risks, population study, CPRD
• Public URL: https://nottingham-repository.worktribe.com/output/977374
• Publisher URL: https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kev418
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Chang-Fu Kuo, Matthew J. Grainge, Christian Mallen, Weiya Zhang, Michael Doherty; Impact of gout on the risk of atrial fibrillation. Rheumatology (Oxford) 2015; 55 (4): 721-728 is available online at: http://dx.doi.org/10.1093/rheumatology/kev418.
• Contract Date: Feb 8, 2017