Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Gout is an independent risk factor for any type of cardiovascular disease (CVD). The exact mechanism behind remains to be elucidated, but persistent crystal-related inflammation is presumed as a key factor. The aim of this study was to assess whether gout characteristics that may indicate a more severe disease and higher inflammatory load are associated with the presence of CVD.
Methods: Case-control study, performed at baseline of an inception cohort including consecutive crystal-proven gout patients seen at a rheumatology unit. Gout features (time since first attack, number of attacks, number of joints ever affected, pattern of presentation, tophi) were registered after interview and physical exam. Presence and duration of CVD (which included coronary heart disease, heart failure, stroke or peripheral artery disease) was registered after interview and records review. Those patients who have suffered from CVD prior to the onset of gout were excluded. Other cardiovascular risk factors, as well as clinical and laboratory variables, were also registered. Odds ratios with 95% confidence intervals (95%CI) for each gout feature were calculated between patients with and without CVD, using a multiple logistic regression model to adjust for confounders.
Results: The inception cohort includes 308 patients; 54 were excluded for this study because gout onset occurred after CVD, so finally 254 cases were analyzed. Mean age was 61.4 years (SD 13.9), being 225 (88.6%) men. Regarding gout, median duration was 5 years (IQR 1-12), median number of reported attacks was 5 (IQR 2-14) that had involved a median of 3 joints (IQR 2-5); presenting attack was monoarticular in 77.4% cases, oligoarticular in 16.7%, and polyarticular in 6%, and 58 patients (22.8%) showed tophi at enrolment. A total of 32 patients (12.6%) had suffered from CVD at enrolment. Table shows the results of logistic regression analysis: time since first attack and polyarticular presentation of gout both significantly associated with the presence of CVD, while other variables showed no association. After multivariate analysis, time since first attack persisted associated with CVD, while polyarticular involvement showed a trend towards signification.
Conclusion: Time since first attack and likely a polyarticular presentation, two variables that may estimate crystal and inflammatory load in gout patients, are independently associated with the presence of CVD, adding evidence to the role of persistent inflammation on its development.
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Association between gout features and cardiovascular disease |
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Simple regression |
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Multiple regression |
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|
OR (95%CI) |
p |
aOR (95%CI)* |
p |
|
|
Time since first attack |
1.07 (1.03-1.10) |
<0.001 |
1.06 (1.02-1.11) |
0.005 |
|
Number of attacks suffered |
1.00 (0.99-1.00) |
0.561 |
– |
– |
|
Number of ever involved joints |
1.09 (0.96-1.22) |
0.177 |
– |
– |
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Joint pattern at presentation |
|
|
|
|
|
i. Monoarticular |
1.0 (ref) |
– |
1.0 (ref) |
– |
|
ii.Oligoarticular |
2.30 (0.93-5.72) |
0.073 |
1.71 (0.44-6.65) |
0.440 |
|
iii.Polyarticular |
3.56 (1.02-12.32) |
0.045 |
5.33 (0.92-30.78) |
0.061 |
|
Tophi |
1.64 (0.73-3.69) |
0.234 |
– |
– |
*aOR: adjusted OR for age, gender, hypertension, diabetes, dyslipidemia, smoking background, obesity, and renal failure.
To cite this abstract in AMA style:
Andrés M, López-Salguero S, Sivera F, Carmona L, Vela P, Pascual E. Gout Characteristics and Its Association with the Presence of Cardiovascular Disease: A Case-Control Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/gout-characteristics-and-its-association-with-the-presence-of-cardiovascular-disease-a-case-control-study/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/gout-characteristics-and-its-association-with-the-presence-of-cardiovascular-disease-a-case-control-study/