Association Between Gout Flare and Subsequent CV Events Among Gout Patients

Numerous studies have demonstrated an association between gout and cardiovascular disease (CVD); however, the association between gout flares and CVD events is far less documented. Gout, caused by high levels of uric acid, is a common form of arthritis. High levels of uric acid in the blood results in it being deposited in and around joints as needle shaped monosodium urate (MSU) crystals, and patients experience joint pain, swelling, redness, and tenderness that can last for 1 to 2 weeks. Researchers at the University of Nottingham, United Kingdom, examined whether there was a temporary increase in risk of heart attack or stroke after a gout flare.

Published in JAMA, a multivariable nested case-control study was performed among 62,574 patients with gout, and a self-controlled case series was performed among 1421 patients with gout flare and cardiovascular event. Primarily evaluating cardiovascular events (defined as acute myocardial infarction or stroke), the association with recent gout flares was measured using adjusted odds ratios. Among patients with gout, 10,475 patients with subsequent heart attacks or strokes were matched with 52,099 patients without any cardiovascular event. Patients with cardiovascular events were twice as likely to have had a gout flare in the 60 days prior to the event, and one and a half times more likely in the preceding 60 to 120 days when compared with patients who did not have cardiovascular events. Additionally, gout patients who died from a cardiovascular event were more than four times as likely to have had experienced a gout flare in the 60 days prior to the event.

Lead author Abhishek Abhishek, PhD, said of the study, “”This is the first study of its kind to examine whether there is an association between recent gout flares and heart attacks and strokes.

“The results show that among patients with gout, patients who experienced a heart attack or stroke had significantly increased odds of a gout flare during the preceding 120-days compared with patients who did not experience such events. These findings suggest that gout flares are associated with a transient increase in cardiovascular events following flares.”