Ticagrelor and the Risk of In-Hospital Gout

Ticagrelor, an effective antiplatelet for acute coronary syndrome (ACS), may elevate serum uric acid (SUA), potentially causing gout. This study aims to identify risk factors for ticagrelor-induced in-hospital gout in patients with ACS and create a predictive model for clinical use.A total of 1164 patients with ACS treated with ticagrelor (n = 640) or clopidogrel (n = 524) were retrospectively analyzed. The incidence of in-hospital gout and changes in SUA levels were compared between the groups. Patients with ticagrelor were further divided into gout and non-gout groups to identify risk factors using logistic regression. A nomogram model was constructed based on significant risk factors.The incidence of in-hospital gout was significantly higher in patients with ticagrelor than in patients with clopidogrel (9.8% versus 1.9%, P < 0.001). There were significant differences in SUA levels between the groups. Logistic regression revealed alcohol consumption, total cholesterol, and baseline SUA as independent risk factors for gout. A nomogram model was developed and demonstrated good predictive accuracy.Ticagrelor was associated with a higher risk of in-hospital gout than clopidogrel in patients with ACS. Alcohol use, total cholesterol, and baseline uric acid are key risk factors. The nomogram model developed in this study can assist in predicting the risk of in-hospital gout in patients with ACS treated with ticagrelor.