medwireNews: Having gout is associated with an increased risk for atrial fibrillation (AF) among people aged 65 years and older, study results suggest.
Jasvinder Singh and John Cleveland, both from the University of Alabama at Birmingham, USA, used Medicare claims data to assess the relationship between gout and AF among 1,647,812 people aged an average of 75 years, 9.8% of whom developed incident AF between 2006 and 2012.
Of the 161,090 individuals who developed AF, 6.6% had a diagnosis of gout, and the unadjusted incidence rates for AF among patients with and without gout were 43.4 and 16.3 per 1000 patient–years, respectively.
After adjusting for factors including demographics, allopurinol or febuxostat use, and comorbidities, people with gout had a significant 92% increased risk for developing AF compared with those without, report the researchers in RMD Open.
They note that this association was attenuated, but still statistically significant, in a model taking AF-specific risk factors such as hypertension, coronary artery disease, and hyperlipidemia into account, with gout patients having a 71% increased risk for AF.
These findings suggest that “[s]creening for AF in people with gout, both in the presence or the absence of heart disease, may lead to early detection and treatment of AF,” say Singh and Cleveland.
“An equally important question” to be addressed in future studies “is whether inhibitors of xanthine oxidase such as allopurinol can independently reduce the risk of AF and could [potentially] treat or prevent AF in high-risk patients,” they add.
The researchers point out that the excess AF risk attributable to gout in this study “was much larger than previously reported”, which they suggest is due to the study’s specific focus on people aged 65 years or older.
Individuals in this age group “have the highest prevalence of gout among all age groups,” as well as being at the highest risk for AF, they explain.
Singh and Cleveland also found that older age (≥85 and 75–84 vs <75 years), White race, and a higher Charlson-Romano comorbidity score were significantly associated with AF risk.
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