Background Gout - an independent risk factor of overall mortality and mortality from cardiovascular disease, serum uric acid levels have almost no effect on the risk of mortality .
Objectives To analyze survival and causes of death in patients with gout.
Methods The study included 305 patients with cristal-verified gout. Patients (pts)were observed in the Research Institute of Rheumatology from 2002 to 2011, 38 patients (12.5%) were not available. Mean age at the beginning of the observation was 51,5±11,4, the monitoring period was 6,1±1,4 years or 1629 person-years. The examination included assessment of the indicators anthropometry, biochemical analysis (lipid and carbohydrate metabolism, renal function, uric acid, hs-CRP), diagnosis of comorbid diseases and metabolic syndrome (MS) (ATP III criteria). Survival was calculated using the Kaplan-Meier method, the odds ratio of death for metabolic syndrome (MS) and its components, chronic kidney disease (CKD), ischemic heart disease (IHD), chronic heart failure (CHF).
Results Survivalof ptswas 95%in 3 years, 93%in 5 years,85% in 7 years from the beginning of the observation. 34 pts died (12.7%). The causes of death in pts were cardiovascular complications (22 pts(65%)), cancer pathology (7 pts(20%)), renal failure (2 pts (6%)), accident (2 pts (6%)), infection (1 patient (3%)). The odds ratio (OR) of death in patients with gout from any cause and cardiovascular accidents, was highfor IHD, CHF, CKD,MS and some of its components (table).
In addition, 34 pts, who died during follow-up, showed highermedian serum hs-CRP: 20.8 [13.6-33.5] mg/l vs 12.5 [5.8-19.0] mg/l (p=0.0041) in the remaining 233 patients, while uric acid and lipid metabolism parameters were comparable.
Conclusions The survival of pts with gout in thelast 7 years of the follow up was 85% and 2/3of those deaths were the complications of cardiovascular diseases. In addition to ischemic heart disease,chronic heart failureand chronic kidney disease, metabolic syndrome and some of its components (rise in blood pressure, hyperglycemia and low HDL-C) are associated with a high chance of total and cardiovascular death in pts with gout. Another adverse factor can be increased hs-CRP.
Kuo C.F., Yu K.H., See L.C., at al. Elevated risk of mortality among gout patients: a comparison with the national population in Taiwan. Joint Bone Spine. 2011 Dec; 78(6): 577-80.
Disclosure of Interest None Declared