Gout May Be a Risk Factor for Aortic Stenosis Progression

Aortic stenosis was found to occur more frequently in patients with vs without gout, according to a study published in the American Journal of Medicine.

In this retrospective review, the data of 1510 consecutive patients aged >65 with aortic stenosis who underwent ≥2 transthoracic echocardiograms (TTEs) at a single center ≥1 year apart were examined. In this cohort, 73 patients with gout and 626 patients without gout met the inclusion criteria (median follow-ups, 903 and 915 days, respectively).

The study’s primary endpoint was severe aortic stenosis, defined as any combination of aortic valve peak velocity >4.0 m/s, mean gradient >40 mm Hg, aortic valve area <1 cm², and/or decrease in left ventricular ejection fraction (LVEF) due to aortic stenosis.

Patients with vs without gout were found to be more likely to have severe aortic stenosis during follow-up, as assessed on TTE (74% vs 54%, respectively; P =.001; hazard ratio [HR], 1.45; 95% CI, 1.09-1.93) in an unadjusted analysis and after adjustment for the presence of severe aortic stenosis on index TTE (HR, 1.43; 95% CI, 1.07-1.91; P =.02).

The association between gout and the development of severe aortic stenosis persisted after adjustment for age, sex, body surface area, hypertension, and glomerular filtration rate (HR, 1.46; 95% CI, 1.03-2.08; P =.03). In patients with a decrease in LVEF associated with the progression of aortic stenosis, gout remained associated with severe aortic stenosis (HR, 1.46; 95% CI, 1.02-2.09; P =.04).

Study limitations include its retrospective nature and single-center design and the inclusion of a relatively small group of patients with gout.

 “[These results] further supports the hypothesis that gout is a risk factor for aortic stenosis,” concluded the study authors.

Disclosure: A study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Adelsheimer A, Shah B, Choy-Shan A, et al. Gout and progression of aortic stenosis [published online February 17, 2020]. Am J Med. doi: 10.1016/j.amjmed.2020.01.019

This article originally appeared on The Cardiology Advisor