降尿酸治疗与心律失常风险降低相关：一项系统评价和荟萃分析。
Urate-lowering therapy is associated with a reduced risk of arrhythmias: a systematic review and meta-analysis.
作者信息
Waitayangkoon Palapun, Leesutipornchai Thiratest, Techasatian Witina, Aiumtrakul Noppawit, Tanariyakul Manasawee, Arayangkool Chinnawat, Kanthajan Tatchaya, Nagamine Todd, Kewcharoen Jakrin
机构信息
Department of Medicine, MetroWest Medical Center, Tufts University School of Medicine, Framingham, MA, USA.
Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA.
出版信息
J Rheum Dis. 2024 Apr 1;31(2):108-115. doi: 10.4078/jrd.2023.0059. Epub 2023 Dec 28.
OBJECTIVE
While urate-lowering therapy (ULT) is linked to increased cardioprotective benefits on primary prevention of cardiovascular events such myocardial infarction or heart failure, little is known regarding their effects on arrhythmia risk. The purpose of this study was to investigate the relationship between incident arrhythmias and ULT.
METHODS
We searched MEDLINE and Embase from inception to May 2023. Included studies were randomized controlled trials and cohort studies that compared the risk of cardiac arrhythmias among ULT users with non-ULT users.
RESULTS
A total of 12,420 patients from five studies were analyzed, comprising 7,359 subjects in the ULT group and 5,061 subjects in the non-ULT group. Our results showed that ULT users had significant reductions in the risk of arrhythmias (pooled relative risk [RR] 0.82, 95% confidence interval [CI] 0.740.92, p<0.001, I2=0.0%) compared to non-ULT users. Subgroup analysis did not show that ULT users had a significant reduced risk of atrial fibrillation (pooled RR 0.76, 95% CI 0.541.05, p=0.096 with I2=15.4%) compared to non-ULT users.
CONCLUSION
ULT is associated with lower risk of overall arrhythmias. Further studies are warranted to confirm our findings.
目的
虽然降尿酸治疗（ULT）与在心血管事件（如心肌梗死或心力衰竭）一级预防中增强心脏保护益处相关，但对于其对心律失常风险的影响知之甚少。本研究的目的是调查新发心律失常与ULT之间的关系。
方法
我们检索了从创刊至2023年5月的MEDLINE和Embase数据库。纳入的研究为随机对照试验和队列研究，比较了ULT使用者与非ULT使用者中心律失常的风险。
结果
对来自五项研究的总共12420名患者进行了分析，其中ULT组有7359名受试者，非ULT组有5061名受试者。我们的结果显示，与非ULT使用者相比，ULT使用者的心律失常风险显著降低（合并相对风险[RR]为0.82，95%置信区间[CI]为0.740.92，p<0.001，I2=0.0%）。亚组分析未显示与非ULT使用者相比，ULT使用者的房颤风险显著降低（合并RR为0.76，95%CI为0.541.05，p=0.096，I2=15.4%）。
结论
ULT与总体心律失常风险较低相关。需要进一步研究来证实我们的发现。
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