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Ticagrelor and the Risk of In-Hospital Gout

Hong Liu1,2, Guo Jiangxue1, Yu Dong1,2

  • 1Department of Cardiology, The First Affiliated Hospital of Dali University.

International Heart Journal
|January 19, 2025
PubMed

Insights

Ticagrelor increases the risk of in-hospital gout in acute coronary syndrome (ACS) patients compared to clopidogrel. Alcohol use, high cholesterol, and elevated baseline uric acid are key risk factors for developing gout.

Area of Science:

  • Cardiology
  • Pharmacology
  • Rheumatology

Background:

  • Ticagrelor is an effective antiplatelet agent for acute coronary syndrome (ACS).
  • Ticagrelor use is associated with elevated serum uric acid (SUA) levels.
  • Elevated SUA can precipitate gout attacks.

Purpose of the Study:

  • Identify risk factors for ticagrelor-induced in-hospital gout in ACS patients.
  • Develop a predictive model for clinical risk assessment of gout in ACS patients on ticagrelor.

Main Methods:

  • Retrospective analysis of 1164 ACS patients treated with ticagrelor or clopidogrel.
  • Comparison of in-hospital gout incidence and SUA level changes between treatment groups.
  • Logistic regression analysis to identify independent risk factors for gout in the ticagrelor group.
  • Construction of a nomogram model for gout risk prediction.

Main Results:

  • In-hospital gout incidence was significantly higher with ticagrelor (9.8%) versus clopidogrel (1.9%) (P < 0.001).
  • Significant differences in SUA levels were observed between the groups.
  • Independent risk factors for gout included alcohol consumption, total cholesterol, and baseline SUA.
  • The developed nomogram model demonstrated good predictive accuracy.

Conclusions:

  • Ticagrelor is associated with a higher risk of in-hospital gout compared to clopidogrel in ACS patients.
  • Alcohol use, total cholesterol, and baseline SUA are critical risk factors for ticagrelor-induced gout.
  • The nomogram provides a valuable tool for predicting in-hospital gout risk in ACS patients receiving ticagrelor.

Keywords:
Acute coronary syndromeAntiplatelet therapyNomogram prediction modelSUA

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