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handle: 20.500.12466/2805
Hypothesis and Objectives: patients with atrial fibrillation (AF) who also have hyperuricemia may have higher morbidity and mortality, compared to those patients who do not. For this reason, we proposed to study mortality and the appearance of adverse events after an episode of AF. Material and methods: 1772 patients treated for an episode of AF in the Emergency Department of our center between 2010 and 2015, with a minimum follow-up of 1 year, were studied. These were distributed in two groups (464 patients with and 1308 without hyperuricemia) and by quartiles of serum uric acid; collecting and analyzing their clinical and analytical data and adverse events. Results: the group with HU presented older age (76,9±11,4 vs 74,7±11,9 years), a higher percentage of comorbidities (hypertension, obesity, chronic kidney disease) and heart failure (32,3% vs 16,4%). Mortality during follow-up (3,7±1,4 years), in the bivariate analysis was significantly higher in patients with HU (52,1%), compared to those without it (35,3%), confirming the Cox multivariate analysis to hyperuricemia as an independent risk factor for death [HR 1,89 (1,59 – 2,25)]. The Kaplan-Meier test showed a shorter survival time in hyperuricemic patients (Log Rank <0,001). There were also significant differences in the risk of hospitalization for cardiovascular causes (39,2% vs 32,5%) and HF (30% vs 22%) in patients with HU, confirmed by Cox analysis. Conclusions: hyperuricemia was associated with a significant and independent increase in mortality in our patients, as well as an increased risk of hospitalizations and HF.
Hipótesis y Objetivos: los pacientes con fibrilación auricular (FA) que presentan, además, hiperuricemia (HU) pueden tener una mayor morbimortalidad respecto los pacientes que no la presentan. Por ello, nos propusimos estudiar la mortalidad y eventos adversos tras un episodio de FA. Material y métodos: se estudiaron 1772 pacientes atendidos por un episodio de FA en Urgencias de nuestro centro entre 2010 y 2015, con seguimiento mínimo de 1 año. Se distribuyeron en dos grupos (464 con HU y 1803 sin HU), y por cuartiles de ácido úrico sérico; recogiendo y analizándose sus datos clínicos, analíticos y eventos adversos. Resultados: el grupo con HU presentó mayor edad (76,9 ± 11,4 vs 74,7 ± 11,9 años), más comorbilidades (HTA, obesidad, enfermedad renal crónica) e insuficiencia cardíaca (32,3% vs 16,4%). La mortalidad durante el seguimiento (3,7 ± 1,4 años) en el análisis bivariado fue mayor (p<0,001) en pacientes con HU (52,1%), respecto a aquéllos sin ella (35,3%), confirmando el análisis multivariante de Cox a la hiperuricemia como factor de riesgo independiente de muerte [HR 1,89 (1,59 – 2,25)]. La prueba de Kaplan-Meier mostró un menor tiempo de supervivencia en hiperuricémicos (Log Rank <0,001). También hubo diferencias significativas en el riesgo de hospitalización de causa cardiovascular (39,2% vs 32,5%) e ICC (30% vs 22%) en los pacientes con HU; confirmándolo el análisis de Cox. Conclusiones: la presencia de hiperuricemia se asoció con un aumento independiente en la mortalidad en nuestros pacientes, así como a un aumento del riesgo de hospitalizaciones e ICC.
Medicina
Ácido úrico, Pronóstico, Hyperuricemia, Prognosis, Atrial fibrillation, Uric acid, 3207.04 Patología Cardiovascular, Fibrilación auricular, Hiperuricemia
Ácido úrico, Pronóstico, Hyperuricemia, Prognosis, Atrial fibrillation, Uric acid, 3207.04 Patología Cardiovascular, Fibrilación auricular, Hiperuricemia
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