Cardiovascular disease (CVD) affects more than 90 million US adults. CVD is also prevalent in individuals with gout. Gout, a form of inflammatory arthritis characterized by severe pain, redness, and tenderness in and around the joints, occurs when too much uric acid (hyperuricemia) crystallizes and deposits in the joints. Prior meta-analyses have shown that hyperuricemia is associated with hypertension and coronary artery disease. Likewise, results from randomized clinical trials have linked gout with increased risks of heart attacks, cerebrovascular accidents, and death from CVD.
A study, published in the Journal of Clinical Rheumatology, investigated whether active gout screening in inpatients with cardiovascular events could help identify patients at higher risk of mortality after hospital discharge.
The study population included 249 patients admitted to San Juan de Alicante University Hospital in Alicante, Spain. Gout was established in patients through patient records and clinical interviews. After patients were discharged from hospital, their medical records were reviewed for mortality and cause of death. Researchers used Cox regression models to determine if there was an association between gout and subsequent mortality.
The mean follow-up period was 19.9 months after hospital discharge. Overall, 14.5% of patients were classified by researchers as having gout, with 13 of those patients being identified via clinical interview. In the both the overall study sample and a subgroup of patients with a prior diagnosis of gout, gout significantly increased the risk of all-cause mortality, with a hazard ratio of 2.01. Furthermore, patients with gout had an increased risk of both cardiovascular and noncardiovascular deaths. Within the gout population, increased age and chronic kidney disease were morality predictors.
“Active screening for gout allowed the detection of a larger population at high risk of mortality and could help tailor patient management to minimize the cardiovascular impact,” the authors of the study concluded.