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Long-term cardiovascular mortality among middle-aged men with gout
Archives of Internal Medicine, 06/02/08

Krishnan E et al. – Among middle-aged men, a diagnosis of gout accompanied by an elevated uric acid level imparts significant independent cardiovascular disease (CVD) mortality risk.

• Study to investigate the association of gouty arthritis (gout) in middle age with long-term CVD mortality
• A 17-yr f/u study of 9105 men, aged 41-63 yrs and at above-average risk for coronary heart disease
• Participants were randomized to who were alive or have clinical or electrocardiographic evidence of coronary artery disease during the 6-yr trial
• Risk of CVD death and other causes subsequent to the sixth annual examination associated with gout was assessed

• The unadjusted mortality rates from CVD among those with and w/o gout were 10.3 per 1000 person-yrs and 8.0 per 1000 person-yrs, respectively, representing an approximately 30% greater risk
• Use of diuretics and aspirin, and serum creatinine level, the hazard ratio (gout vs no gout) for coronary heart disease mortality was 1.35
• The hazard ratio for death from myocardial infarction was 1.35; for death from CVD overall, 1.21; and for death from any cause, 1.09
• The association between hyperuricemia and CVD was weak and did not persist when analysis was limited to men with hyperuricemia w/o a diagnosis of gout

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