A study has examined the risk of atrial fibrillation ( AF ) at the time of first diagnosis of gout compared with matched controls and has followed incident gout patients and their matched controls after diagnosis to compare their subsequent risk of atrial fibrillation.
From the UK Clinical Practice Research Datalink, 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 atria fibrillation 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 body mass index ( BMI ), smoking, alcohol consumption, ischaemic heart disease, heart failure, heart valve disease, hyperthyroidism and other comorbidities and medications.
The prevalence of atrial fibrillation 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 odds ratio ( 95% CI ) was 1.45 ( 1.29, 1.62 ). The cumulative probability of atrial fibrillation 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 less than 0.001 ).
The adjusted hazard ratio ( 95% CIs ) was 1.09 ( 1.03, 1.16 ).
In conclusion, this population-based study has indicated that gout is independently associated with a higher risk of atrial fibrillation at diagnosis and the risk is also higher after the diagnosis. ( Xagena )
Kuo CF et al, Rheumatology 2015; Epub ahead of print