Association of Serum Uric Acid With Incident Atrial Fibrillation (from the Atherosclerosis Risk in Communities [ARIC] Study)

Atrial fibrillation (AF) is one of the most common arrhythmias seen in clinical practice. Current evidence suggests that serum uric acid (SUA) could be a marker of oxidative damage a factor reported as part of the mechanisms of AF. The purpose of this study was to evaluate if SUA predicted AF in the Atherosclerosis Risk in Communities study (ARIC). This analysis included 15,382 AF-free black and white men and women, aged 45-64, from the ARIC study, a population-based prospective cohort in the US. SUA was determined using the uricase-peroxidase method at baseline. The primary outcome was the incidence of AF defined as the occurrence of AF detected from hospital discharge codes, scheduled study electrocardiograms (ECG) and /or death certificates during follow-up period (1987-2004). We identified 1085 cases of incident AF. In Cox proportional hazards models adjusted for age, sex, race, center, education, body-mass index, serum glucose, systolic and diastolic blood pressure, LDL cholesterol, alcohol use, prevalent coronary heart disease and heart failure, serum creatinine, use of diuretics, and p wave duration on the ECG (as a measure of left atrial size) at baseline, the hazard ratio (HR) of AF associated with a 1-standard deviation increment in SUA was 1.16; 95% CI 1.06 -1.26. The association of SUA with AF risk differed by race and gender (p for interactio