For a study, researchers sought to find out if a recent gout flare-up caused a temporary increase in the risk of cardiovascular events.
Between January 1, 1997, and December 31, 2020, electronic health records from the Clinical Practice Research Datalink in England were used in a retrospective observational research. Among 62,574 gout patients, a multivariable nested case-control research was conducted, and among 1,421 gout flare and cardiovascular event patients, a self-controlled case series, adjusted for season and age, was conducted. Utilizing hospitalization, primary care outpatient, and medication information, gout flares were identified. A cardiovascular event, such as a stroke or an acute myocardial infarction, was the main outcome. In a nested case-control study and a self-controlled case series, associations with recent past gout flares were assessed using adjusted odds ratios (ORs) with 95% CIs and adjusted incidence rate ratios (IRRs).
About 10,475 individuals with later cardiovascular events were compared with 52,099 patients without cardiovascular events among patients with a new diagnosis of gout (mean age, 76.5 years; 69.3% men, 30.7% women). Patients who had cardiovascular events had significantly higher odds of experiencing a gout flare in the 0 to 60 days prior (204/10,475 [2.0%] vs 743/52,099 [1.4%]; adjusted OR, 1.93 [95% CI, 1.57-2.38]) and 61 to 120 days prior (170/10,475 [1.6%] vs 628/52,099 [1.2%]; adjusted OR, 1.57 [95% CI, 1.26-1.96]). The probabilities of a gout flare within the previous 121 to 180 days did not differ significantly (148/10 475 [1.4%] versus 662/52 099 [1.3%]; adjusted OR, 1.06 [95% CI, 0.84-1.34]). Compared to cardiovascular event rates of 1.32 (95% CI, 1.23-1.41) per 1,000 person-days within the 150 days prior to or the 181 to 540 days after the gout flare, the self-controlled case series (N = 1,421) had cardiovascular event rates of 2.49 (95% CI, 2.16-2.82) within days 0 to 60, 2.16 (95% CI, 1.85-2.47) within days 61 to 120, and 1.70 (95% CI, 1.42-1.98) within days 121 to 180 after a gout flare, compared with cardiovascular event rates of 1.32 (95% CI, 1.23-1.41) per 1,000 person-days within the 150 days before or the 181 to 540 days after the gout flare, adjusted IRRs were 1.89 (95% CI, 1.54-2.30) within days 0 to 60; 0.84 (95% CI, 0.52-1.17) per 1,000 person-days and 1.64 (95% CI incidence rate differences for cardiovascular events were 1.17 (95% CI, 0.83-1.52) per 1000 person-days, and, 1.45-1.86) within days 61 to 120; and 0.38 (95% CI, 0.09-0.67) per 1,000 person-days and 1.29 (95% CI, 1.02-1.64) within days 121 to 180 after a gout flare.
In people with gout, those who had a cardiovascular incident had considerably greater odds of recently experiencing a gout flare in the days prior to the event than those who did not. These results implied that gout flares were connected to a brief rise in cardiovascular events after the flare.
Reference: jamanetwork.com/journals/jama/article-abstract/2794763
