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Crystal-proven Gout and Characteristic Gout Severity Factors Are Associated with Cardiovascular Disease
Iris J M Disveld1,2, Jaap Fransen1,2, Gerard A Rongen1,2
1From the Department of Rheumatology, Rijnstate Hospital, Arnhem; Department of Rheumatology, Radboud University Medical Centre; Departments of Internal Medicine, and Pharmacology and Toxicology, Radboud University Medical Centre; Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen; Department of Dermatology, University Medical Centre Utrecht, Utrecht, the Netherlands.
Insights
Crystal-proven gout significantly increases the risk of cardiovascular disease (CVD). Gout severity factors like disease duration and joint damage are linked to prevalent CVD, suggesting a shared pathway.
Area of Science:
- Rheumatology
- Cardiology
- Epidemiology
Background:
- Gout is a common inflammatory arthritis characterized by monosodium urate crystal deposition.
- Cardiovascular disease (CVD) is a leading cause of mortality and morbidity worldwide.
- A potential link between gout and CVD has been suggested but requires further investigation.
Purpose of the Study:
- To determine the prevalence of CVD in patients with crystal-proven gout compared to arthritis controls.
- To analyze the association between gout severity factors and CVD to support a pathogenetic relationship.
Main Methods:
- A cohort study including 700 gout patients and 276 arthritis controls.
- CVD and gout severity factors (disease duration, attack frequency, tophi, affected joints, serum urate, joint damage) were assessed.
- Statistical analysis compared CVD prevalence and associated factors between groups.
Main Results:
- CVD was present in 47% of gout patients versus 24% of controls.
- Gout remained strongly associated with increased CVD prevalence after adjusting for confounders (OR 3.39).
- Gout severity factors including disease duration (≥2 years), polyarthritis, high serum urate, and joint damage were independently associated with CVD.
Conclusions:
- Crystal-proven gout is strongly associated with a higher prevalence of CVD.
- Gout severity factors are linked to CVD, supporting a pathogenetic relationship between the two conditions.
Objective:
Our aim was to examine the prevalence of cardiovascular disease (CVD) in patients with crystal-proven gout compared to arthritis controls. Further, we analyzed the association between characteristic gout severity factors and CVD to provide further support for a pathogenetic relationship between gout and CVD.
Methods:
Patients with arthritis referred for diagnosis were consecutively included in the Gout Arnhem-Liemers cohort. Joint fluid analysis was performed in all referred patients; controls were negative for crystals. Patients' characteristics and different manifestations of CVD and gout severity factors (disease duration, attack frequency, tophi, affected joints, high serum urate acid level, joint damage) were collected. Gout patients were compared with controls for the prevalence of CVD. In addition, the association between characteristic gout severity factors and presence of CVD was analyzed.
Results:
Data from 700 gout patients and 276 controls were collected. CVD was present in 47% (95% CI 44%-51%) and 24% (95% CI 19%-29%) of gout patients and controls, respectively. Corrected for confounders, gout was still strongly associated with an increased prevalence of CVD compared to controls (OR 3.39, 95% CI 2.37-4.84). In patients with gout, disease duration ≥ 2 years, oligo- or polyarthritis, serum urate acid > 0.55 mmol/l at presentation, and joint damage were independently (p < 0.05) associated with prevalent CVD.
Conclusion:
Crystal-proven gout was strongly associated with an increased prevalence of CVD. In patients with gout, characteristic gout severity factors were associated with CVD.
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