Association between gout and atrial fibrillation: A meta-analysis of observational studies

Abstract

Background: Gout is a systemic inflammatory arthritis characterized by the deposition of monosodium urate crystals due to hyperuricemia. Previous studies have explored the link between gout and atrial fibrillation (AF). Given the increasing prevalence and incidence of gout, there is a need to quantify the relationship between gout and the risk of AF. Therefore, we conducted a systematic review and meta-analysis on this topic. Methods: PubMed and Embase were searched for studies that reported the association between gout and AF using the following search term: (‘Gout’ and ‘Arrhythmia’). The search period was from the start of the database to 3rd August 2018 with no language restrictions. Results: A total of 75 and 22 articles were retrieved from PubMed and Embase, respectively. Of these, four observational studies (three cohort studies, one case-control study) including 659,094 patients were included. Our meta-analysis demonstrated that gout was significantly associated with increased risk of AF (adjusted hazard ratio: 1.31; 95% confidence interval: 1.00-1.70; P = 0.05; I2 = 99%) after adjusting for significant comorbidities and confounders. Conclusions: Our meta-analysis confirms the significant relationship between gout and AF. More data are needed to determine whether this risk can be adequately reduced by urate-lowering therapy.