Relationship between serum uric acid levels and different types of atrial fibrillation: An updated meta-analysis

Aim: Increasing evidence supports the hypothesis that high serum uric acid (SUA) levels are related to atrial fibrillation (AF). However, the incidence of AF in patients with hyper-uricemia and SUA levels in different types of AF is not entirely clear. This meta-analysis was de-signed to evaluate the relationship between SUA and incidence of AF, and the variation in SUA levels in different types of AF. Data synthesis: Relevant reports were searched for in Embase, PubMed and the Cochrane Library. A fixed-effects model combining relative risk (RR) and the corresponding 95% confidence interval (95% CI) was used to evaluate the correlation between SUA and AF. The standardized mean dif-ferences (SMDs) of SUA values were calculated using a random-effects model to evaluate the dif-ferences in SUA levels among different types of AF. A total of 31 studies with 504,958 participants were included in this research. The results from 8 cohort studies showed that high SUA levels significantly increased the incidence of AF [RR (95% CI): 1.92 (1.68-2.20); P < 0.01]. The results from 29 studies revealed that SUA levels elevated in patients with AF [SMD (95% CI): 0.55 (0.43-0.66); P < 0.001]. Meanwhile, SUA levels in new-onset AF [SMD (95%CI): 0.24 (0.10-0.38); P Z 0.001], paroxysmal AF [SMD (95%CI): 0.52 (0.33-0.72); P < 0.001] and persistent AF [SMD (95%CI): 1.23 (0.98-1.4 8); P < 0.001] were signifi-cantly higher than that in patients without AF. Conclusions: High SUA levels had an obvious correlation with the occurrence rate of AF. In addi-tion, SUA levels were significantly different among patients with new-onset, paroxysmal and persistent AF. (c) 2021 Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clin-ical Medicine and Surgery, Federico II University.