ROLE OF GOUT IN ATRIAL FIBRILLATION

Abstract

Atrial fibrillation (AF) is the most prevalent arrhythmia in clinical practice. Atrial fibrillation (AF) is the most prevalent arrhythmia in clinical practice. There is increasing evidence for the role of inflammation in the development and maintenance of AF and gout is associated with inflammation and oxidative stress. In the last years several studies were published to assess the role of gout as a risk factor for occurrence of atrial fibrillation (AF). There are not enough data on the importance of gout in patients, who already have AF. The aim of the study is to assess the impact of gout on the clinical course of AF. Overall 101 patients – 51 females and 50 males at mean age 68,02 ± 7,001, with AF after sinus rhythm restoration were included in a clinical trial of one-year placebo-controlled treatment with spironolactone. Gout was reported in 6,8% of them. They were analyzed for AF recurrence, hospitalization for AF, all-cause admissions, composite endpoint (recurrence episodes of AF, all-cause hospitalization and death) and value of biomarker Galectin-3 (Gal-3). Results: Patients with gout had double risk of recurrence of AF, even though not significant, HR=1.97, 95%CI=0,78-4.98, p=0,15. In our study presence of gout was significant predictor for hospitalization for AF in unifactor analysis (HR 4,46, 95% CI=1.51 – 13.19, p=0,007) and the only significant in multifactor analysis – model, including gender, age categories, hypertension, diabetes and use of spironolactone (HR=4,23, 95%CI=1,28–14,1, p=0,018). Gout influenced significant also the all-cause hospitalizations, HR =3.17, 95%CI 1.10-9.14, p=0.033. There was a significant difference between the value of Gal-3 in patients with gout as opposed to patients without (28,52±15 vs 16,02±5,49, р=0,002). Conclusion: We found that gout significantly influences the course of AF. Presence of gout in patients with atrial fibrillation is a risk factor for recurrence and hospitalization – cause-specific for AF and all-cause. The value of Gal-3 as a marker of fibrosis and inflammation is higher in patients with AF and gout.