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

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.