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Clinical and epidemiological research
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Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study
  1. Mary A De Vera1,2,
  2. M Mushfiqur Rahman1,2,
  3. Vidula Bhole1,
  4. Jacek A Kopec1,2,
  5. Hyon K Choi1,2,3,4
  1. 1Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
  2. 2School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Rheumatology Division, Department of Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
  4. 4Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Hyon K Choi, Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, 650 Albany Street, Suite 200, Boston, MA 02118, USA; hchoius{at}bu.edu

Abstract

Background Men with gout have been found to have an increased risk of acute myocardial infarction (AMI), but no corresponding data are available among women.

Objective To evaluate the potential independent association between gout and the risk of AMI among elderly women, aged ≥65 years.

Methods A population-based cohort study was conducted using the British Columbia Linked Health Database and compared incidence rates of AMI between 9642 gout patients and 48 210 controls, with no history of ischaemic heart disease. Cox proportional hazards models stratified by gender were used to estimate the relative risk (RR) for AMI, adjusting for age, comorbidities and prescription drug use.

Results Over a 7-year median follow-up, 3268 incident AMI cases, were identified, 996 among women. Compared with women without gout, the multivariate RRs among women with gout were 1.39 (95% CI 1.20 to 1.61) for all AMI and 1.41 (95% CI 1.19 to 1.67) for non-fatal AMI. These RRs were significantly larger than those among men (multivariate RRs for all AMI and non-fatal AMI, 1.11 and 1.11; p values for interaction, 0.003 and 0.005, respectively).

Conclusion These population-based data suggest that women with gout have an increased risk for AMI and the magnitude of excess risk is higher than in men.

https://doi.org/10.1136/ard.2009.122770

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    Footnotes

    • Competing interests MADV receives training support from the Canadian Arthritis Network/The Arthritis Society, the Michael Smith Foundation for Health Research and the Canadian Institutes of Health Research. MMR receives training support from the Canadian Arthritis Network/The Arthritis Society. VB receives postdoctoral training fellowship support from the Canadian Arthritis Network/The Arthritis Society. HKC has received research funding from TAP Pharmaceuticals for other research projects. In addition, HKC has received honoraria from, and serves as a consultant to, TAP Pharmaceuticals and Savient.

    • Funding This work was supported in part by grants from the National Institute of Health (AR047785).

    • Ethics approval This study was conducted with the approval of the University of British Columbia.

    • Provenance and peer review Not commissioned; externally peer reviewed.