Background/Purpose: Osteoarthritis
(OA) and gout are each associated with increased cardiovascular disease (CVD),
but their relative impacts on CV risk are not known. We compared rates of CVD
among patients with OA (OA-only), gout (gout-only), or both (gout+OA).

Methods:  We used ICD-9 codes to identify male
patients from within our VA health care system with OA-only, gout-only, or gout+OA, and an active medical record between August 2007
and August 2008. For each group, we collected baseline demographics and CVD
risk factors. The primary outcome was a composite index (CV4) consisting of any
diagnosis of myocardial infarction (MI), angina, coronary bypass surgery (CABG),
and/or coronary artery disease (CAD). Secondary outcomes included individual
diagnoses within the CV4, congestive heart failure (CHF) and death. Logistic
regression was used to compare the associations of OA-only, gout-only, and gout+OA with CV outcomes, adjusting for traditional CV risk
factors: age, race, hypertension (HTN), diabetes mellitus, hyperlipidemia (HLD),
chronic kidney disease (CKD), and smoking.  

Results:  1280 gout subjects met inclusion criteria (983
gout-only, 297 gout+OA), along with 1231 OA-only
subjects. Gout subjects, with or without OA, had more CVD risk factors at
baseline, including HTN, HLD and CKD vs. OA-only. In an unadjusted model,
a diagnosis of gout increased the risk for CV4, CAD, angina, CABG, CHF, and death
compared to a diagnosis of OA-only. In a fully adjusted model, gout-only
subjects continued to have increased risk for all outcomes except MI and death
compared to OA-only subjects, while gout+OA subjects
exhibited increased risk for angina and CHF (Table 1). Gout+OA
did not impart additional risk over gout-only for any outcome except CABG.

Conclusion: Our data suggest
that gout is associated with higher risk of CVD compared with OA, that at least
some of this increased risk may be independent of traditional risk factors, and
that OA does not impart additive CVD risk to patients who also have gout.