Shimojo Kazuki, Morishima Itsuro, Morita Yasuhiro, Kanzaki Yasunori, Miyazawa Hiroyuki, Watanabe Naoki, Yoshioka Naoki, Shibata Naoki, Arao Yoshihito, Yamauchi Ryota, Ohi Takuma, Goto Hiroki, Karasawa Hoshito, Okumura Kenji
Department of Cardiology Ogaki Municipal Hospital Ogaki Japan.
Department of Cardiology Tohno Kosei Hospital Mizunami Japan.
J Arrhythm. 2024 Jun 19;40(4):849-857. doi: 10.1002/joa3.13092. eCollection 2024 Aug.
Evidence regarding the association between hyperuricemia and arrhythmia recurrence after catheter ablation for paroxysmal atrial fibrillation (AF) is scarce. We investigated whether hyperuricemia predicts arrhythmia recurrence after catheter ablation for paroxysmal AF and the relationship between hyperuricemia and alcohol consumption in AF recurrence.
Patients who underwent catheter ablation for paroxysmal AF were divided into the hyperuricemia (index serum uric acid [UA] >7.0 mg/dL; = 114) and control (UA ≤7.0 mg/dL; = 609) groups and were followed for a median of 24 (12-48) months after ablation.
The hyperuricemia group had more patients with an alcohol intake of ≥20 g/day (33.3% vs. 22.7%, = .017) and a lower incidence of AF-free survival ( = .019). Similarly, those with an alcohol intake of ≥20 g/day had a lower incidence of AF-free survival than other patients. Multivariate Cox regression analysis revealed the following independent predictors of AF recurrence (adjusted hazard ratio, 95% confidence interval): hyperuricemia (1.64, 1.12-2.40), female gender (1.91, 1.36-2.67), brain natriuretic peptide level >100 pg/mL (1.59, 1.14-2.22), and alcohol consumption ≥20 g/day (1.49, 1.03-2.15) (all < .05). In addition, causal mediation analysis revealed that alcohol consumption of ≥20 g/day directly affected AF recurrence, independent of hyperuricemia.
Patients with hyperuricemia may be at a high risk of arrhythmia recurrence after catheter ablation for paroxysmal AF. Although high alcohol consumption may contribute to increased UA levels, the presence of hyperuricemia may independently predict AF recurrence.
关于高尿酸血症与阵发性心房颤动（AF）导管消融术后心律失常复发之间关联的证据稀少。我们研究了高尿酸血症是否可预测阵发性AF导管消融术后的心律失常复发，以及高尿酸血症与AF复发中酒精摄入之间的关系。
接受阵发性AF导管消融术的患者被分为高尿酸血症组（血清尿酸[UA]指数>7.0mg/dL；n = 114）和对照组（UA≤7.0mg/dL；n = 609），并在消融术后进行了中位时间为24（12 - 48）个月的随访。
高尿酸血症组中每日酒精摄入量≥20g的患者更多（33.3%对22.7%，P = 0.017），且无AF生存的发生率更低（P = 0.019）。同样，每日酒精摄入量≥20g的患者无AF生存的发生率低于其他患者。多因素Cox回归分析揭示了AF复发的以下独立预测因素（调整后的风险比，95%置信区间）：高尿酸血症（1.64，1.12 - 2.40）、女性性别（1.91，1.36 - 2.67）、脑钠肽水平>100pg/mL（1.59，1.14 - 2.22）以及每日酒精摄入量≥20g（1.49，1.03 - 2.15）（均P < 0.05）。此外，因果中介分析表明，每日酒精摄入量≥g直接影响AF复发，独立于高尿酸血症。
高尿酸血症患者在阵发性AF导管消融术后可能有较高的心律失常复发风险。虽然大量饮酒可能导致UA水平升高，但高尿酸血症的存在可能独立预测AF复发。
