The association between hyperuricemia, left atrial size and new-onset atrial fibrillation

Tze Fan Chao, Chung Lieh Hung, Su Jung Chen, Kang Ling Wang, Tzeng Ji Chen, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


Background Although hyperuricemia was associated with several cardiovascular diseases, the role of uric acid (UA) in left atrial (LA) remodeling and new-onset atrial fibrillation (AF) has not been fully explored. The goal of the present study is to investigate the relationship between UA, LA diameter and the development of AF in the large-scale cohort. Methods The study consisted of 2 parts. First, we investigated the association between serum UA and LA diameter in a single-center database (n = 3043). Second, we studied and compared the risk of new-onset AF among patients with and without hyperuricemia in the nationwide longitudinal cohort in Taiwan (n = 122,524). Results Elevated serum level of UA was associated with an increased systemic inflammation, and insulin resistance. The LA diameter was significantly correlated with serum UA (r = 0.341, p value < 0.001). The linear correlation between LA dimension and UA level remained significant after the adjustment for clinical, biochemical and echocardiographic variables. In the nationwide cohort, there were 2339 patients (1.9% of the study population) developing AF during the follow-up of 6.3 ± 3.0 years. The AF occurrence rate was higher in patients with hyperuricemia than those without it (2.1% versus 1.7%; p value < 0.001). Hyperuricemia was a significant risk factor of new-onset AF with a hazard ratio of 1.191 (95% confidence interval = 1.098-1.292, p value < 0.001) in the multivariate Cox regression analysis. Conclusions Hyperuricemia was associated with a larger LA size and may be a novel risk factor for the development of AF.

Original languageEnglish
Pages (from-to)4027-4032
Number of pages6
JournalInternational Journal of Cardiology
Issue number4
StatePublished - 9 Oct 2013


  • Atrial fibrillation
  • Hyperuricemia
  • Left atrium
  • Uric acid


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