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THU0506 Cardiovascular Risk and Endothelial Dysfunction in Patients with Gout: Experience in A Multihospital spanish Group
  1. E. Calvo Aranda1,
  2. O. Carriόn2,
  3. A. Abdelkader2,
  4. J. González1,
  5. F. Aramburu1,
  6. M. Valero1,
  7. S. Rodriguez1,
  8. C. Marin1,
  9. C. Sangüesa1,
  10. I. Amil1,
  11. F. Saiz2,
  12. P. García de la Peña1
  1. 1Rheumatology
  2. 2Vascular Surgery, HM Hospitales, madrid, Spain

Abstract

Background Several reports have shown the relationship between gout and increased cardiovascular risk (CVR). There is a lack of research in Spain about endothelial and cardiac dysfunction in gout

Objectives Analyze CVR factors in gouty patients in our sample with vascular assessment, cardiological tests and laboratory parameters

Methods Prospective cohort study with collection of clinical data, family history (FH) of gout and cardiovascular disease (CVD), and treatments received (calcium channel antagonists [CCA], ACE inhibitors [ACE-i], angiotensin receptor blokers [ARB], beta blockers [BB] or thiazides. A history of hypertension, diabetes (DM), dyslipidemia (DL), smoking, thrombotic events, ischemic heart disease (IHD) were also collected. Body mass index (BMI), serum uric acid (SUA), sedimentation rate (ESR), conventional/ultrasensitive RCP [cRCP, hsCRP], ferritin, total cholesterol (CHOL) and subtypes (HDLc, LDLc), triglycerides (TG), vitamin D and homocysteine were measured. Patients were referred to Vascular Surgery Department for ultrasound examination with search of carotid plaques and study of intima-media thickness (IMT), and also were to Cardiology Department for echocardiogram (ECHO-CG) and electrocardiogram (ECG)

Results 150 patients, 97% men and 3% women. Average age at time of study and diagnosis: 56 (23–92) and 47 years (15–79), respectively. Age at symptoms onset: 45 years (15–77). 22.5% had tophi and 11.3% urate stones. FH: 42% had gout history and 41% CVD history. Classical CVR factors: hypertension 47.3%; DM-2 4.6%, glucose intolerance 0.6%; DL 56.7% (CHOL: 37, TG: 15, both: 33); smokers 20.6% and quitters 37.6%, 21 pack/year (1–90); 1 patient had suffered stroke; 4 thrombosis; 17 IHD (11 angina, 6 myocardial infarction). 75% overweight/obesity, BMI 28 (19–40). Analytical parameters: ESR 10 mm/h (1–68), hs-CRP 2.7 mg/dL (0.1–57.7), c-CRP 2.3 mg/L (0–14.8); SUA 6.9 mg/dL (2.4–11.8); ferritin 259 ng/ml (11–2000); COL-t: 187 mg/dL (102–321, 6 not collected [NC]), HDLc 47 mg/dL (15–88; 22 NC), LDLc 113 mg/dL (15–248) TG 145 mg/dL (53–603); vitamin D 24.7 ng/mL (5.6–23.6; 28.6% <20); homocysteine 24.7 mmol/L (4–40; 32% >15 mmol/L). ECHO-CG: 6 valvular disease, 13 left ventricular hypertrophy, 45 had >1 finding, 5 NC. ECG was normal in 79 patients; 9 right bundle branch block (BBB), 1 left BBB, 4 IHD signs, 2 repolarization abnormalities and 6 arrhythmia; 13 had ≥2 findings, 9 showed other findings, 54 NC. Vascular examination: carotid IMT greater than corresponding adjusted by age group in 75% and 79% of patients (right and left, respectively); both: 65%. Carotid plaques 23%. Treatments: ACA 2.6%, ACE-i 2%, ARB 4.6%, BB 2%, thiazides 3.3%

Conclusions 75% of our patients have overweight/obesity. High percentage of subjects with hyperhomocysteinemia and/or vitamin D deficiency. Marked prevalence of increased IMT and carotid plaques, and outstanding number of cardiac abnormalities in ECHO-G/ECG. Further statistical studies will quantify the value of these early findings, that seem very relevant

  1. Feig DI, et al. Uric acid and cardiovascular risk. N Engl J Med. 2008;359(17):1811–21

  2. Çukurova S, et al.Subclinical atherosclerosis in gouty arthritis patients: a comparative study. Rheumatol Int. 2012;32(6):1769–73

Disclosure of Interest None declared

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