Session Information
Date: Monday, October 22, 2018
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: To determine whether the Taiwanese patients with gout have a higher risk of stroke.
Methods: Using the National Health Insurance database, we identified a cohort of new-onset gout patients in Taiwan between 2000 and 2005, follow up till 2015. The gout cohort was frequency-matched according to birth year and gender with patients without gout (control cohort). Cumulative probability and multivariable hazard ratio (HR) adjusted by age, sex, Charlson comorbidity index and co-medication was performed to evaluated the risk of stroke, including ischemic and hemorrhage stroke.
Results: In this study, we identified 646,983 incident patients with 1:1 matched of control group without gout. The incidence (100 person-years) of ischemic stroke and hemorrhagic stroke were both higher in gout group [7.26 (95% CI, 7.19-7.33); 2.47 (95% CI, 2.42 – 2.51) respectively] than control group [5.95 (95% CI, 5.88 – 6.01); 2.04 (95% CI, 2-2.07), respectively]. Both risk of ischemic stroke and hemorrhage stroke were higher in gout group (HR 1.15, 95% CI 1.14-1.17; HR 1.17, 95% CI 1.14-1.20, respectively) (Table).
Conclusion: Patients in Taiwan with gout have a higher risk of stroke, including ischemic stroke and hemorrhagic stroke. The incidence of ischemic stroke was three-fold than hemorrhagic stroke in gout patient.
Table Clinical characteristics of patients and Hazard ratios for incidence of stroke.
|
Gout (n= 646,983) |
No Gout (n= 646,983) |
P Value |
|
|
Sex, No. (%) |
|
|
|
|
Male |
473362(73.16) |
473362(73.16) |
1.0000 |
|
Female |
173611(26.83) |
173611(26.83) |
|
|
Age, mean (SD), y |
49.63 (17.18) |
49.62 (17.18) |
0.9476 |
|
Hypertension |
165148(25.53) |
107091(16.55) |
<.0001 |
|
Ischemic stroke
|
|
|
|
|
Incidence/100 person-years(95%CI) |
7.26(7.19-7.33) |
5.95(5.88-6.01) |
|
|
No. of case, (%) |
39812(6.15) |
32619(5.04) |
|
|
Age and sex adjusted Hazard Ratio(95%CI) |
1.26(1.24-1.28)* |
1.0 |
|
|
Multivariable Hazard Ratio﹟ (95% CI) |
1.16(1.14-1.18)* |
1.0 |
|
|
Multivariable Hazard Ratio† (95% CI) |
1.15(1.14-1.17)* |
1.0 |
|
|
Hemorrhagic stroke
|
|
|
|
|
Incidence/100 person-years(95%CI) |
2.47(2.42-2.51) |
2.04(2-2.07) |
|
|
No. of case, (%) |
13703(2.12) |
11289(1.74) |
|
|
Age and sex adjusted Hazard Ratio(95%CI) |
1.23(1.20-1.26)* |
1.0 |
|
|
Multivariable Hazard Ratio﹟ (95% CI) |
1.16(1.13-1.19)* |
1.0 |
|
|
Multivariable Hazard Ratio† (95% CI) |
1.17(1.14-1.20)* |
1.0 |
|
|
﹟adjusted for age, sex and charlson comorbidity index (myocardial infarction, congestive heart disease, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, Renal failure, peptic ulcer disease, mild liver disease, moderate or severe liver disease, diabetes and diabetes with complications, hemiplegia and paraplegia, any malignancy including leukaemia and lymphoma, metastatic tumour, human immunodeficiency virus [HIV] infection and hypertension). †adjusted for age, sex, charlson comorbidity index (myocardial infarction, congestive heart disease, peripheral vascular disease, cerebrovascular disease, dementia, chronic pulmonary disease, Renal failure, peptic ulcer disease, mild liver disease, moderate or severe liver disease, diabetes and diabetes with complications, hemiplegia and paraplegia, any malignancy including leukaemia and lymphoma, metastatic tumour, human immunodeficiency virus [HIV] infection and hypertension), NSAID, Colchicine, Prednisolone, PPI, Vitamin D, Bisphosphonates, Glucocorticoids, insulin, glucose, antihypertensives, nitrates, lipid, anticonvulsants, anticoagulants and DMARD. |
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To cite this abstract in AMA style:
Tsai PH, Kuo CF. Risk of Stroke Among Patients with Gout in Taiwan: A Nationwide Population Study [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/risk-of-stroke-among-patients-with-gout-in-taiwan-a-nationwide-population-study/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/risk-of-stroke-among-patients-with-gout-in-taiwan-a-nationwide-population-study/