Correlation Between Hyperuricemia And CHA₂DS₂-VASc Score In Patients With Nonvalvular Atrial Fibrillation

Objective:To investigate the correlation between Hyperuricemia and CHA₂DS₂-VASc score in patients with Nonvalvular atrial fibrillation.Materials and Methods:A total of 638 patients,including 410 male patients and 228 female patients,with an average age of 72.35±11.00（years）,who were discharged from the Department of Cardiovascular Medicine of our Hospital and diagnosed as Nonvalvular atrial fibrillation（NVAF）on October 2018 and solstice on December 2020 were collected.CHA₂DS₂-VASc score of all patients was calculated,and 70 patients were divided into the low group（<2 points）and 568 patients in the high group（≥2 points）according to the score results.The general clinical data,Serological indicators,and cardiac ultrasound parameters were compared between the two groups.Binary Logistic regression was used to select the predictors of high CHA₂DS₂-VASc score（≥2 points）.Spearman correlation analysis was used to evaluate the correlation between uric acid and CHA₂DS₂-VASc score.Results:1.According to the CHA₂DS₂-VASc score results,the patients were divided into two groups with a total number of 638 patients,including 70patients in the low group（<2 points）and 568 patients in the high group（≥2 points）.There were statistically significant differences in Low in age,the proportion of women between groups,heart failure,hypertension,stroke,diabetes,Hyperuricemia（HUA）,red blood cell distribution width（RDW）,hemoglobin,lymphocyte,low density lipoprotein cholesterol（LDL-C）,total cholesterol（TC）and uric acid（UA）,albumin,D-dimer,glycosylated hemoglobin（Hb A1c）,left atrial diameter（LAD）,right atrium diameter（RAD）,left ventricular ejection fraction（LVEF）between the low and high groups（P<0.05）,The differences had no statistical significance between the low and high groups in smoking,drinking alcohol,white blood cell count,platelet,neutrophils,triglycerides,high-density lipoprotein cholesterol（HDL-C）,creatinine,total bile acid,indirect bilirubin,total bilirubin,AST,potassium,sodium,CRP,fibrinogen,lactic acid,interventricular septum thickness（LVSd）（P>0.05）;The proportion of hyperuricemia patients with high CHA₂DS₂-VASc score was significantly higher than that with low CHA₂DS₂-VASc score.2.Patients were divided into normal uric acid group and hyperuricemia group according to their uric acid level,and the proportion of people with high and low score of CHA₂DS₂-VASc in different groups was calculated.Among them,the high CHA₂DS₂-VASc score was 84.27%in the normal uric acid group,and 93.75%in the hyperuricemia group.Compared with the normal uric acid group,the proportion of patients with high CHA₂DS₂-VASc score was higher in the hyperuricemia group,with statistical significance（P<0.001）.3.With CHA₂DS₂-VASc score as independent variable,the variables with statistically significant differences in univariate analysis included age,HUA,RDW,hemoglobin,lymphocyte,LDL-C,TC,albumin,D-dimer,Hb A1c,LAD,RAD,and LVEF.Multivariate Logistic regression analysis using the above statistically significant indicators in univariate analysis as independent variables showed that hyperuricemia was one of the independent predictors of CHA₂DS₂-VASc score≥2 points（OR=2.18,95%CI:1.036-4.843,P=0.04）,Other variables such as RDW（OR=1.292,95%CI:1.18-2.20,P=0.003）、Hb A1c（OR=2.14,95%CI:1.277-4.541,P=0.007）、LVEF（OR=0.97,95%CI:0.941-0.997,P=0.029）、age（OR=1.172,95%CI:1.132-1.224,P<0.001）were also independent predictors of CHA₂DS₂-VASc score≥2 points.4.Pearson correlation analysis showed that uric acid was positively correlated with RDW（r=0.220,P<0.001）,negatively correlated with LVEF（r=-0.335,P<0.001）,and had no significant correlation with Hb A1c（r=0.049,P=0.214）.Spearman correlation analysis showed that uric acid was positively correlated with CHA₂DS₂-VASc score（r_s=0.151,P<0.001）.Conclusion:Hyperuricemia was associated with higher CHA₂DS₂-VASc score（≥2 points）in patients with NVAF,and the higher the serum uric acid,the higher the CHA₂DS₂-VASc score.