Summary of large studies assessing the risk of cardiac disease in patients with gout
| Study/country/randomised vs cohort | Population | Odds/risk/hazard ratios (95% CI p value) | Covariates adjusted for in multivariable adjusted model |
|---|---|---|---|
| Krishnan et al21/USA/MRFIT | 12 866 men in the MRFIT who were followed up for a mean of 6.5 years | Hyperuricaemia 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/Framingham | 5209 subjects originally enrolled in the Framingham Study | Gout and coronary heart disease: RR 1.60 (95% CI 1.1 to 2.2) in men | Systolic blood pressure, total cholesterol, alcohol intake, body mass index, and diabetes |
| Gelber et al23/USA/two cohorts of black and white physicians | Prospective cohort studies of former medical students—371 black men in the Meharry Cohort Study and 1181 white men in the Johns Hopkins Precursors Study | Gout 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–control | Data were obtained from the Continuous Morbidity Registration (CMR), Nijmegen | Gout 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 cohort | 9642 gout patients and 48 210 controls, with no history of ischaemic heart disease | Gout 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/cohort | 51 297 male participants of the Health Professionals Follow-Up Study with 12 year follow-up | In 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 subjects | 234 794 patients on dialysis in the US Renal Data System | Gout 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 Taiwan | 61 527 subjects, with 1311 with gout | Gout 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.