The relationship between uric acid albumin ratio (UAR) and prognosis in patients with atrial fibrillation hospitalized in intensive care unit

Year 2024, Volume: 7 Issue: 5, 505 - 508, 27.09.2024

Azmi Eyiol , Birsen Ertekin

https://doi.org/10.32322/jhsm.1513638

Abstract

Aims: Recent studies have demonstrated an association between uric acid (UA) albumin ratio (UAR), and newly developing atrial fibrillation (AF) and also AF recurrence. We conducted a study to examine the prognostic value of UAR in critically ill patients with AF.
Methods: A retrospective examination was conducted on patients diagnosed with AF based on electrocardiography, who admitted to the intensive care unit (ICU) from the emergency department during the period from January 1st to May 1st, 2024. UAR levels were calculated by dividing the amount of UA by the amount of albumin. Based on the cut-off value, UAR levels were categorized into two groups: low UAR and high UAR. A comprehensive comparison was conducted on all the data between these two groups.
Results: The high UAR (UAR>0.231) group exhibited significantly higher UA, vasopressor requirement, mechanical ventilation support, length of stay in ICU, and in-hospital mortality rate compared to the low UAR (UAR≤0.231) group. Conversely, albumin levels were significantly lower (p<0.001 for all). The UAR cut-off value was 0.231, with a sensitivity of 97.3% and a specificity of 96.7% (The area under the curve (AUC):0.995, p<0.001). The mortality prediction ability of UAR was superior to that of albumin and UA alone (AUC: 0.995, 0.956, 0.981, respectively).
Conclusion: UAR is a cost-effective, easily accessible, useful marker for assessing the prognosis of critically ill patients with AF in ICU.

Keywords

Uric acid albumin ratio, atrial fibrillation, intensive care unit, prognosis, mortality

Ethical Statement

The study was initiated with the approval of the Necmettin Erbakan University Medical Faculty Clinical Researches Ethics Committee (Date: 28/06/2024, Decision No:2024/5038[ID:19894]).

Supporting Institution

Yoktur

Thanks

yoktur

References

• fibrillation (AFIB) in the ICU: Incidence, risk factors, and outcomes: the International AFIB-ICU cohort study. Crit Care Med. 2023;51(9):1124-1137.
• Glaser K, Marino L, Stubnya JD, Bilotta F. Machine learning in the prediction and detection of new-onset atrial fibrillation in ICU: a systematic review. J Anesth. 2024;38(3):301-308.
• Karataş MB, Durmuş G, Zengin A, et al. Association of uric acid albumin ratio with recurrence of atrial fibrillation after cryoballoon catheter ablation. Medicina (Kaunas). 2022;58(12): 1872.
• Wang X, Hou Y, Wang X, et al. Relationship between serum uric acid levels and different types of atrial fibrillation: an updated meta-analysis. Nutr Metab Cardiovasc Dis. 2021;31(10):2756-2765.
• Arques S. Human serum albumin in cardiovascular diseases. Eur J Intern Med. 2018;52:8-12.
• Wang Y, Du P, Xiao Q, et al. Relationship between serum albumin and risk of atrial fibrillation: a dose-response meta-analysis. Front Nutr. 2021;8:728353.
• Şaylık F, Çınar T, Akbulut T, Selçuk M. Serum uric acid to albumin ratio can predict contrast-induced nephropathy in ST-elevation myocardial ınfarction patients undergoing primary percutaneous coronary intervention. Angiology. 2023;74(1):70-78.
• Çakmak EÖ, Bayam E, Çelik M, et al. Uric acid-to-albumin ratio: a novel marker for the extent of coronary artery disease in patients with non-ST-elevated myocardial infarction. Pulse (Basel). 2021;8(3-4):99-107.
• Selçuk M, Çınar T, Şaylık F, et al. Predictive value of uric acid/albumin ratio for the prediction of new-onset atrial fibrillation in patients with ST-elevation myocardial infarction. Rev Invest Clin. 2022;74(3):156-164.
• Gao Z, Shi H, Xu W, et al. Hyperuricemia increases the risk of atrial fibrillation: a systematic review and meta-analysis. Int J Endocrinol. 2022;2022:8172639.
• Deng Y, Liu F, Yang X, Xia Y. The Key role of uric acid in oxidative stress, inflammation, fibrosis, apoptosis, and immunity in the pathogenesis of atrial fibrillation. Front Cardiovasc Med. 2021;8: 641136.
• Kuwabara M, Niwa K, Nishihara S, et al. Hyperuricemia is an independent competing risk factor for atrial fibrillation. Int J Cardiol. 2017;231:137-142.
• Zhao D, Jiao H, Zhong X, Wang W, Li L. The association between serum albumin levels and related metabolic factors and atrial fibrillation: a retrospective study. Medicine (Baltimore). 2022; 101(44):e31581.
• van Beek DEC, Kuijpers YAM, Königs MHH, van der Horst ICC, Scheeren TWL. Low serum albumin levels and new-onset atrial fibrillation in the ICU: a prospective cohort study. J Crit Care. 2020;56:26-30.
• Liao LZ, Zhang SZ, Li WD, et al. Serum albümin and atrial fibrillation insights from epidemiological and mendelian randomization studies. Eur J Epidemiol. 2020;35(2):113-122.
• Yeter H, Yıldırım T, Eyüpoğlu D, et al. Mild to moderate proteinuria is a heralding sign for acute kidney injury and mortality for intensive care unit patients. Turk J Med Sci. 2019; 49(2):543-550.
• Özgür Y, Akın S, Yılmaz NG, Gücün M, Keskin Ö. Uric acid albumin ratio as a predictive marker of short-term mortality in patients with acute kidney injury. Clin Exp Emerg Med. 2021; 8(2):82-88.
• Kalkan S, Cagan Efe S, Karagöz A, et al. A new predictor of mortality in ST-elevation myocardial infarction: the uric acid albumin ratio. Angiology. 2022;73(5):461-469.