Background/Purpose: We have recently noted by active screening that about a third of gout cases in the cardiovascular population is not registered in records (Calabuig, Front Med 2020), highlighting the value of field studies. This study aims to assess whether gout screening in patients hospitalized for cardiovascular events may also help identify patients at higher risk of mortality after discharge.

Methods: A retrospective cohort field study carried out on 266 patients admitted for cardiovascular events in the Cardiology, Neurology and Vascular Surgery units of a tertiary centre in Spain. The presence of gout was established by records review and face-to-face interview, according to the 2015 ACR/EULAR criteria. The occurrence of mortality during follow-up and its causes were obtained from electronic medical records. The association between gout and subsequent mortality was tested using Cox regression models. Whether covariates affected the gout-associated mortality was also studied.

Results: Of 266 patients recruited at baseline, 17 were excluded due to loss to follow-up ( >6mo), leaving a final sample of 249 patients (93.6%). Thirty-six cases (14.5% of the sample) were classified as having gout: twenty-three (63.9%) had a previously registered diagnosis, while 13 (36.1%) had not and was established by the interview.

After discharge, the mean follow-up was 19.9 months (SD ±8.6), with a mortality incidence of 21.6 deaths per 100 patient-years, 34.2% by cardiovascular causes.
Gout significantly increased the risk of subsequent all-cause mortality, with a hazard ratio (HR) of 2.01 (95%CI 1.13 to 3.58). The association remained significant when the analysis was restricted to gout patients with a registered diagnosis (HR 2.89; 95%CI 1.54 to 5.41).

The adjusted HR for all-cause mortality associated with gout was 1.86 (95% CI 1.01-3.40). Regarding the causes of death, both cardiovascular and non-cardiovascular were numerically increased.
Secondary variables raising the mortality risk in those with gout were age (HR 1.07; 1.01 to 1.13) and coexistent renal disease (HR 4.70; 1.31 to 16.84), while gender, gout characteristics or traditional risk factors showed no impact.

Conclusion: Gout was confirmed as an independent predictor of subsequent all-cause mortality in patients admitted for cardiovascular events. Active screening for gout allowed identifying a larger population at high mortality risk and may help tailor optimal management to minimize the cardiovascular impact.

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/active-screening-for-gout-permits-identifying-a-larger-cardiovascular-population-at-high-mortality-risk/