Crystal-Proven Gout, Gout Severity Factors Linked to Cardiovascular Disease

Crystal-proven gout and characteristic gout severity factors are associated with an increased prevalence of cardiovascular disease (CVD), according to the results of a cross-sectional study published in The Journal of Rheumatology.

The investigators sought to examine the prevalence of CVD in patients with crystal-proven gout compared with control patients with arthritis. They also analyzed the relationship between characteristic gout severity factors and CVD to provide support for a pathogenic link between gout and CVD.

Individuals with arthritis referred for diagnosis were included in the Gout Arnhem-Liemers cohort. All patients received joint fluid analysis, and controls were designated as those who tested negative for crystals. Patient characteristics, along with various manifestations of CVD and gout severity factors, including disease duration, tophi, affected joints, joint damage, high serum urate acid levels, and frequency of attacks, were compiled.

Data were collected from 700 patients with gout and 276 controls. CVD was detected in 47% of individuals with gout (95% CI, 44%-51%) and 24% of controls (95% CI, 19%-29%). After adjustments for confounders, the presence of gout was still strongly associated with an elevated prevalence of CVD compared with controls (odds ratio [OR], 3.39; 95% CI, 2.37-4.84).

In participants with gout, the following severity factors were all independently and significantly associated with prevalent CVD: disease duration ≥2 years (OR, 1.58; 95% CI, 1.14-2.20; P =.006), oligoarthritis or polyarthritis (OR, 1.93; 95% CI, 1.33-2.81; P =.001), serum urate acid level >0.55 mmol/L (OR, 2.32; 95% CI, 1.66-3.25; P <.001), and joint damage (OR, 3.63; 95% CI, 2.40-5.50; P <.001).

The investigators concluded that experimental evidence is needed to establish the clinically relevant cardiovascular benefit of reducing serum urate levels or preventing gout-related inflammation.

Reference

Disveld IJM, Fransen J, Rongen GA, et al. Crystal-proven gout and characteristic gout severity factors are associated with cardiovascular disease [published online April 15, 2018]. J Rheumatol. doi:10.3899/jrheum.170555