Gout and Cardiovascular Disease: Crystallized Confusion

Aryeh M. Abeles; Michael H. Pillinge


Curr Opin Rheumatol. 2019;31(2):118-124. 

In This Article

Gout as an Independent Cardiovascular Risk Factor

Multiple studies established that gout sufferers have increased risk of coronary artery disease (CAD) and cardiovascular death compared with the general population.[2,6–8] More recent studies confirm these earlier observations.[9–12] In one retrospective cohort study accessing a Medicare database, gout was an independent predictor of incident MI in a subgroup of patients lacking other CAD risk factors (including hyperlipidemia, diabetes, and hypertension).[10] Similarly, Disveld et al. retrospectively matched patients with crystal-proven gout to those with nongouty arthritis. Even after accounting for multiple potentially confounding variables, patients with gout maintained a higher prevalence of cardiovascular disease [odds ratio (OR) 3.39].[11] Andres et al.enrolled 237 consecutive patients with crystal-proven gout, and stratified them for traditional cardiovascular risk factors and medical history; patients not initially classified as 'very high' risk underwent carotid ultrasound. Among 142 patients assessed, 80 had their risk upgraded after carotid US; 66 moved into the very high-risk stratum.[12]