High uric acid level predicts left atrial thrombus or spontaneous echo contrast detected by transesophageal echocardiography: Meta-analysis and systematic review

Abstract

Background: Recent observational studies have suggested that the patients with hyperuricemia have a higher risk of having left atrial thrombus (LATH) or left atrial spontaneous echo contrast (LASEC) by transesophageal echocardiography (TEE), while the ultimate predictive value of a high uric acid (UA) level on LATH/LASEC remained obscure. Methods: We searched the PubMed and Cochrane clinical trials databases up to July 2015. Following screening the 369 initially identified studies, we analyzed six observational studies with 2381 patients. Results: The meta-analysis of these studies showed that an elevated serum UA level was associated with a higher likelihood of LATH/LASEC (OR = 1.59, 95%CI 1.13–2.23, P = 0.008), while significant differences exist among individual trials (P < 0.00001 and I2 = 85%). Sensitivity analysis failed to find any heterogeneity. Conclusion: An elevated UA level was associated with a higher risk of detecting a left atrial abnormality represented by LATH/LASEC. Keywords: Uric acid, Left atrium, Thrombus, Transesophageal echocardiography, Atrial fibrillation