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Gout May Not Be Associated With Cardiovascular Complications in Peripheral Artery Disease

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Gout May Not Be Associated With Cardiovascular Complications in Peripheral Artery Disease

Gout was not found to be associated with increased risk for cardiovascular complications in patients with peripheral artery disease (PAD), according to the results of a multi-center prospective cohort study published in Atherosclerosis.

Patients (n=4308) were recruited from 4 outpatient clinics beginning in 2002. All participants had been diagnosed with PAD by a vascular specialist. Gout was diagnosed based on the International Classification of Disease 9 or 10 criteria. Patients were assessed for major adverse cardiovascular events and mortality.

In total, 43.2% of participants had comorbid abdominal aortic or peripheral aneurysm, 23.6% had intermittent claudication, 21.9% had carotid artery stenosis, 11.3% had critical limb ischemia, and 7.8% of had gout.

At baseline, patients with vs without gout (n=334 and n=3974, respectively) differed in: median age (73 vs 70 years, respectively; P <.001), male gender (88.6% vs 74.4%, respectively; P <.001), rate of hypertension (53.9% vs 75.0%, respectively; P <.001), rate of coronary heart disease (53.9% vs 46.4%, respectively; P =.008), percentage of participants on statin therapy (74.3% vs 68.9%, respectively; P =.040), and median estimated glomerular filtration rate (65 vs 76 mL/min/1.73m2, respectively; P <.001). After propensity matching, the difference between patients with vs without gout (n=334 and n=299, respectively) remained for estimated glomerular filtration rate (65 vs 71 mL/min/1.73m2, respectively; P =.023).

In the entire cohort, patients with vs without gout were at greater risk for major cardiovascular events (hazard ratio [HR], 1.37; 95% CI, 1.09-1.71; P =.006) and mortality (HR, 1.38; 95% CI, 1.13-1.68; P =.002). However, in the propensity-matched cohort, this difference was not observed (cardiovascular complication: HR, 1.06; 95% CI, 0.78-1.44; P =.717 and mortality: HR, 1.06; 95% CI, 0.81-1.39; P =.681).

A major limitation of this study was that patients were not stratified according to PAD type.

“The results [of this study] do not suggest an independent association between gout and cardiovascular events amongst individuals with PAD,” concluded the study authors.

Reference

Singh T P, Wong S, Quigley F, et al. Association of gout with major adverse cardiovascular events and all-cause mortality in patients with peripheral artery disease. Atherosclerosis. 2020;312:23-27. doi:10.1016/j.atherosclerosis.2020.08.029

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