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Urate-lowering therapy may mitigate the risks of hospitalized stroke and mortality in patients with gout

Fu-Shun Yen1, Chih-Cheng Hsu2,3,4, Hsin-Lun Li5,6

  • 1Dr. Yen's Clinic, Taoyuan City, Taiwan.

Plos One
|June 24, 2020
PubMed

Insights

Urate-lowering therapy (ULT) significantly reduces the risk of stroke and all-cause mortality in gout patients. This finding suggests ULT may be beneficial for cardiovascular health in this population.

Area of Science:

  • Cardiology
  • Rheumatology
  • Epidemiology

Background:

  • Hyperuricemia is linked to cardiovascular (CV) diseases.
  • Limited research exists on the impact of urate-lowering therapy (ULT) on CV disease incidence.
  • Gout patients are a key population for studying these effects.

Purpose of the Study:

  • To compare the risks of hospitalized coronary artery disease (CAD), stroke, heart failure (HF), and all-cause mortality.
  • To evaluate these risks between ULT users and nonusers among patients diagnosed with gout.

Main Methods:

  • Retrospective cohort study utilizing Taiwan's National Health Insurance Research Database (2000-2012).
  • Included 5218 patients with gout, comparing ULT users with matched nonusers.
  • Analyzed incidence rates (IRs) and adjusted hazard ratios (aHR) for key CV events and mortality.

Main Results:

  • ULT users had significantly lower adjusted hazard ratios for hospitalized stroke (aHR: 0.52) and all-cause mortality (aHR: 0.6) compared to nonusers.
  • Incidence rates of hospitalized stroke were 0.6 per 100 person-years for ULT users versus 1.0 for nonusers.
  • Uricosuric agents and xanthine oxidase inhibitors showed significant associations with reduced stroke and mortality risks, respectively, with a dose-response for uricosurics on stroke risk.

Conclusions:

  • ULT use is associated with reduced risks of hospitalized stroke and all-cause mortality in patients with gout.
  • These findings suggest that ULT can be a strategy to mitigate cardiovascular and mortality risks in gout patients.
  • Further research into specific ULT agents and their CV benefits is warranted.
Abstract

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