Abhishek Abhishek, MBBS, MD, FRCP, PhD

Compared with patients with gout who did not experience a cardiovascular (CV) event, those who did had notably higher odds of a recent gout flare, according to a study published in JAMA Network.

Although this investigation suggests a link between gout flares and a transient rise in CV events, such a link has not been studied, explains Abhishek Abhishek, MBBS, MD, FRCP, PhD.

To examine the link between gout flares and CV events, Dr. Abhishek and colleagues conducted a retrospective observational study using EHR data collected between January 1, 1997, and December 31, 2020. Among 62,574 patients with gout, researchers performed a multivariate, nested case-control study. In addition, a self-controlled care series was conducted among 1,421 patients who experience gout flare with a CV event, adjusted for age and season. A CV event, defined as a stroke or acute myocardial infarction, was the primary outcome.

Patients With Gout With CV Events Had Significantly High Odds of Flare

A total of 52,099 patients without CV events were matched with 10,475 patients with subsequent CV events. Compared with those who did not have CV events, researchers noted that patients with CV events had significantly higher odds of gout flare within the prior 0-60 days (adjusted OR, 1.93 [95% CI, 1.57-2.38]) and within the prior 61-120 days (adjusted OR, 1.57 [95% CI, 1.26-1.96]). Within the prior 121-180 days, no notable differences were found in the odds for gout flare.

In the self-controlled case series, CV event rates per 1,000 person-days after a gout flare were 2.49 (95% CI, 2.16-2.82) within days 0-60; 2.16 (95% CI, 1.85-2.47) within days 61-120; and 1.70 (95% CI, 1.42-1.98) within days 121-180.  This was compared with CV rates after a gout flare of 1.32 (95% CI, 1.23-1.41) per 1,000 person-days within the 150 days before or the 181-540 days.

Compared with 150 days before or 181-540 days after a gout flare, rate differences for CV events were 1.17 (95% CI, 0.83-1.52) per 1,000 person-days, and adjusted incidence rate ratios were 1.89 (95% CI, 1.54-2.30) within days 0-60; 0.84 (95% CI, 0.52-1.17) per 1,000 person-days and 1.64 (95% CI, 1.45-1.86) within days 61-120; 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 121-180 after a gout flare.

“These findings suggest gout flares are associated with a transient increase in [CV] events following the flare,” the study authors wrote.