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Impact of gout on cardiovascular disease mortality: a meta-analysis
Jielin Yuan1, Zhitao Xie1, Bo Pan1
1The Second Nanning People's Hospital, The Third Affiliated Hospital of Guangxi Medical University, No.13 Dancun Road, Jiangnan District, 530031, Nanning, Guangxi Zhuang Autonomous Region, China.
Insights
Gout patients face a significantly higher risk of death from cardiovascular diseases (CVD), including coronary heart disease (CHD) and myocardial infarction (MI). This meta-analysis confirms a strong association between gout and increased CVD mortality.
Area of Science:
- Cardiology
- Rheumatology
- Epidemiology
Background:
- Conflicting epidemiological data exist regarding the association between gout and cardiovascular disease (CVD) mortality.
- Some studies suggest a higher risk in gout patients, while others show no clear link.
- This study aimed to clarify the relative risk of CVD mortality in individuals with gout.
Purpose of the Study:
- To investigate the association between gout and cardiovascular disease (CVD) mortality.
- To quantify the relative risk of CVD mortality in gout patients compared to healthy controls.
Main Methods:
- A comprehensive literature search was conducted in major scientific databases (Google Scholar, PubMed, Web of Science) for studies published before March 2023.
- A meta-analysis was performed to summarize the impact of gout on CVD mortality.
- Hazard ratios (HRs) and 95% confidence intervals (CIs) were analyzed using STATA 12.0 software.
Main Results:
- Gout patients exhibited a significantly higher risk of CVD mortality (HR 1.30, 95% CI 1.15-1.48).
- The risk for coronary heart disease (CHD) mortality was also elevated (HR 1.28, 95% CI 1.12-1.46).
- A statistically significant increased risk for myocardial infarction (MI) mortality was observed (HR 1.13, 95% CI 1.00-1.27).
Conclusions:
- This meta-analysis provides robust evidence linking gout to a markedly increased risk of mortality from cardiovascular diseases.
- Patients with gout face higher mortality risks for overall CVD, CHD, and MI compared to those without gout.
- The findings underscore the importance of considering cardiovascular risk in gout management.
Background:
Several epidemiological studies have suggested that gout patients have a higher risk of cardiovascular disease mortality than healthy people. In contrast, the association between gout and cardiovascular disease (CVD) mortality was not obvious in other studies. In the present study, we aimed to investigate the relative risk for CVD mortality in gout patients in comparison to healthy controls.
Methods:
Literature published before March 2023 was searched in Google Scholar, PubMed, and the Web of Science. We summarized the impact of gout on CVD mortality with a meta-analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) regarding the impact of gout on CVD mortality were summarized with STATA 12.0 software.
Results:
Compared to individuals without gout, those with gout had higher mortality risks for CVD during follow-up, with a random effects model showing a risk of 1.30 (95% CI 1.15 to 1.48, p < 0.001; p-value for Cochran Q test < 0.001, I2 = 95.9%). Similarly, subjects with gout had a mortality risk of 1.28 (95% CI 1.12 to 1.46, p < 0.001; p-value for Cochran Q test = 0.050, I2 = 50.2%) for coronary heart disease (CHD) mortality during follow-up using the same statistical model. Furthermore, using a fixed effects model, individuals with gout had a mortality risk of 1.13 (95% CI 1.00 to 1.27, p = 0.049; p-value for Cochran Q test = 0.494, I2 = 0.0%) for myocardial infarction (MI) mortality during follow-up.
Conclusion:
In conclusion, this meta-analysis provides evidence supporting a markedly increased mortality risk from CVD and CHD as well as MI in patients with gout relative to reference subjects without gout.
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