Table 1

Summary of large studies assessing the risk of cardiac disease in patients with gout

Study/country/randomised vs cohortPopulationOdds/risk/hazard ratios (95% CI p value)Covariates adjusted for in multivariable adjusted model
Krishnan et al21/USA/MRFIT12 866 men in the MRFIT who were followed up for a mean of 6.5 yearsHyperuricaemia and MI: OR 1.11 (95% CI 1.08 to 1.15)
Gout and MI: OR 1.26 (95% CI 1.14 to 1.40)
Age, diastolic blood pressure, total serum cholesterol, BMI, fasting blood glucose, smoking, creatinine, diuretic use, aspirin use, alcohol use, incident diabetes, family history of acute MI
Abbott et al22/USA/Framingham5209 subjects originally enrolled in the Framingham StudyGout and coronary heart disease: RR 1.60 (95% CI 1.1 to 2.2) in menSystolic blood pressure, total cholesterol, alcohol intake, body mass index, and diabetes
Gelber et al23/USA/two cohorts of black and white physiciansProspective cohort studies of former medical students—371 black men in the Meharry Cohort Study and 1181 white men in the Johns Hopkins Precursors StudyGout and incident CHD: RR 1.20 (95% CI 0.37 to 3.92) in Meharry men
RR 0.66 (95% CI 0.24 to 1.79) in Johns Hopkins men
Known CHD risk factors
Janssens et al24/Netherlands/case–controlData were obtained from the Continuous Morbidity Registration (CMR), NijmegenGout and incident CVS disease: RR 0.98 (95% CI 0.65 to 1.47)Matched for age, sex and practice
De Vera et al25/British Columbia/population-based cohort9642 gout patients and 48 210 controls, with no history of ischaemic heart diseaseGout in women: RR 1.39 (95% CI 1.20 to 1.61) for all AMI and
RR 1.41 (95% CI 1.19 to 1.67) for non-fatal AMI
Gout in men: RR 1.11 (95% CI 0.99 to 1.23) for all AMI and
RR 1.11 (95% CI 0.98 to 1.25) for non-fatal AMI
Age, comorbidities (hypertension, diabetes, COPD, and hyperlipidaemia), Charlson comorbidity score and prescription drug use (non-steroidal anti-inflammatory drugs, aspirin, glucocorticoids, statins, anticoagulants, hormone replacement therapy and diuretics) as time-dependent covariates
Choi et al26/Health Professionals Follow-up Study/cohort51 297 male participants of the Health Professionals Follow-Up Study with 12 year follow-upIn patients with no pre-existing CAD—Gout and total mortality: RR 1.28 (95% CI 1.15 to 1.41)
Gout and CVD deaths: RR 1.38 (95% CI 1.15 to 1.66)
Gout and fatal CHD: RR 1.55 (95% CI 1.24 to 1.93)
Age, hypertension, hypercholesterolaemia, diabetes mellitus, aspirin use, diuretic use, smoking, body mass index, alcohol intake, family history of MI, total energy intake, trans fat, dietary cholesterol, protein, linoleic fatty acid, and the ratio of polyunsaturated fat to saturated fat
Cohen et al27/US Renal Data System dialysis subjects234 794 patients on dialysis in the US Renal Data SystemGout and mortality: HR 1.47 (95% CI 1.26 to 1.59)Age, sex, diabetes, COPD, peripheral vascular disease, smoking, ischaemic heart disease, congestive heart failure, albumin, smoking
Kuo et al28/Chang Gung Memorial Hospital in Taiwan61 527 subjects, with 1311 with goutGout and all-cause death: HR 1.46 (95% CI 1.12 to 1.91)
Hyperuricaemia and all-cause death: HR 1.07 (95% CI 0.94 to 1.22)
Age, sex, component number of metabolic syndrome and proteinuria
  • AMI, acute myocardial infarction; BMI, body mass index, CAD, coronary artery disease; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease; CVS, cardiovascular; MI, myocardial infarction; MRFIT, Multiple Risk Factor Intervention Trial; RR, relative risk.