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Is there a rise in risk of cardiovascular events following recent gout flares?

Gout flares Gout flares
Gout flares Gout flares

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In people with gout, cardiovascular events are briefly more common after a flare-up.

In gout patients, those who had a cardiovascular incident had a substantially higher chance of recently encountering a gout flare in the days before the event than those who did not have such an event, as deciphered from a retrospective observational study published in "JAMA". Edoardo Cipolletta et al. aimed to determine if a recent gout flare-up causes a temporary elevation in cardiovascular events.

Clinical Practice Research Datalink's electronic medical data were used. A multivariable nested case-control study was held among 62 574 gout subjects, and a self-controlled case series with season and age adjustments was held among 1421 cardiovascular event and gout flare subjects. Utilizing medication information, primary care outpatient, and hospitalization, gout flares were identified.

A cardiovascular event, like stroke or acute myocardial infarction, was the major endpoint. In a self-controlled case series, the link with recent prior gout flares was assessed utilizing adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs), and in a nested case-control study, it was assessed utilizing adjusted odds ratios (ORs) with 95% CIs. Notably, 10, 475 individuals with cardiovascular events occurring subsequently were contrasted with 52, 099 subjects without cardiovascular events among individuals with a new gout diagnosis (mean age, 76.5 years; 30.7% women, 69.3% men).

Individuals who had cardiovascular events had substantially greater odds of experiencing gout flare within the previous 0-60 days (204/10 475 [2.0%] versus 743/52 099 [1.4%]; adjusted OR, 1.93) and within the previous 61-120 days (170/10 475 [1.6%] versus 628/52 099 [1.2%]; adjusted OR, 1.57) compared to patients who did not have cardiovascular events. The possibilities of gout flare within the previous 121-180 days (148/10 475 [1.4%] versus 662/52 099 [1.3%]; adjusted OR, 1.06) had no discernible difference.

Contrasted with cardiovascular event rates of 1.32 per 1000 person-days within 150 days before or 181-540 days following the gout flare, the self-controlled case series (n=1421) exhibited cardiovascular event rates of 2.49 within days 0-60, 2.16 within days 61-120, and 1.70 within days 121-180 per 1000 person-days after a gout flare. Cardiovascular events had an incidence rate difference of 1.17 per 1000 person-days contrasted to 150 days prior to or 181-540 days following a gout flare, and their adjusted IRRs were 1.89 within days 0-60, 0.84 per 1000 person-days and 1.64 within days 61-120, and 0.38 per 1000 person-days and 1.29 within days 121-180 following a gout flare. These findings imply that gout flares are related to a transitory rise in cardiovascular events post-flare.

Source:

JAMA

Article:

Association Between Gout Flare and Subsequent Cardiovascular Events Among Patients With Gout

Authors:

Edoardo Cipolletta et al.

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