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The association between gout and cardiovascular disease in patients with atrial fibrillation

Per Wändell1, Axel C Carlsson1,2, Jan Sundquist3,4,5

  • 1Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden.

SN Comprehensive Clinical Medicine
|August 10, 2019
PubMed

Insights

Gout is linked to several cardiometabolic diseases in atrial fibrillation patients. However, gout appears to reduce the risk of ischemic stroke, improving predictive models.

Area of Science:

  • Cardiology
  • Metabolic Diseases
  • Epidemiology

Background:

  • Gout is a metabolic disorder associated with cardiovascular diseases.
  • Atrial fibrillation (AF) patients often have co-existing cardiovascular conditions.
  • Understanding the interplay between gout and cardiovascular comorbidities in AF is crucial.

Purpose of the Study:

  • To investigate the associations between gout and various cardiovascular comorbidities in patients diagnosed with atrial fibrillation (AF).
  • To assess the impact of gout on the incidence of congestive heart failure (CHF) and ischemic stroke (IS) in AF patients.

Main Methods:

  • The study included 12,283 adult patients (≥45 years) with AF from Swedish primary care centers (2001-2007).
  • Logistic regression analyzed associations between prevalent gout and cardiovascular comorbidities.
  • Cox regression evaluated incident CHF and IS, calculating hazard ratios (HR) and 95% confidence intervals (CIs).

Main Results:

  • Gout showed significant positive associations with CHF, obesity, and diabetes in both sexes.
  • In men, gout was also linked to hypertension and coronary heart disease.
  • Prevalent gout was negatively associated with incident ischemic stroke (IS), with HRs of 0.64 and 0.50 in different models.

Conclusions:

  • Gout is associated with most cardiometabolic diseases in AF patients, excluding cerebrovascular diseases.
  • Gout demonstrates a decreased risk of ischemic stroke (IS) in this population.
  • Including gout in risk assessment models significantly enhances predictive value compared to CHA2DS2-VASc alone.
Abstract

Keywords:
Atrial fibrillationCongestive heart failureGenderGoutHypertensionIschemic stroke

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