Crystal-proven gout linked to cardiovascular disease

A robust association exists between crystal-proven gout and increased prevalence of cardiovascular disease (CVD), a recent study has found. Additionally, characteristic gout severity factors correlate with CVD in patients with gout.

Data were obtained from a total of 700 gout patients and 276 controls. CVD was present in 47 percent (95 percent CI, 44–51 percent) of gout patients and 24 percent (19–29 percent) of controls. After adjusting for confounders, the strong correlation persisted between gout and an increased prevalence of CVD (odds ratio, 3.39; 2.37–4.84).

The following factors were independently associated with prevalent CVD (p<0.05) in patients with gout: disease duration ≥2 years, oligo- or polyarthritis, serum urate acid >0.55 mmol/l at presentation, and joint damage.

In this study that sought to assess the prevalence of CVD in patients with crystal-proven gout vs arthritis controls, the authors consecutively included patients with arthritis referred for diagnosis in the Gout Arnhem-Liemers cohort. Joint analysis was conducted in all referred patients, and controls were negative for crystals.

The authors also collected patients’ characteristics and different manifestations of CVD as well as gout severity factors (eg, disease duration, attack frequency, tophi, affected joints, high serum urate acid level and joint damage). They then compared gout patients with controls for the prevalence of CVD. Finally, an analysis was performed on the association between characteristic gout severity factors and presence of CVD.

A 2017 study suggested that gout patients with CVD were more likely to have additional comorbidities, more gout-related symptoms and a delay in treatment initiation, which may be associated with greater severity of disease. [J Manag Care Spec Pharm 2017;23:677-683]