Gout as a Risk Factor for Acute Myocardial Infarction: Evidence from Competing Risk Model Analysis

Abstract

Chronic inflammation, a hallmark of gout, is implicated in the pathogenesis of atherosclerosis. Thus, in theory, gout can be expected to increase the risk of acute myocardial infarction (AMI). Yet, results from several epidemiological studies have been inconclusive. A retrospective cohort study was conducted using the National Health Insurance Research Database of Taiwan dated from 2000 to 2013. The study cohort comprised 3581 patients with gout (the gout cohort) and 14,324 patients without gout (the non-gout cohort). The primary outcome was the incidence of AMI. To estimate the effect of gout on the risk of AMI, the Lunn-McNeil competing risk model was fitted to estimate cause-specific hazard ratios (HRs) and their 95% confidence intervals (CIs). The cumulative incidence of AMI was significantly higher in the gout cohort than in the non-gout cohort, resulting in an adjusted HR of 1.36 (95% CI 1.04 to 2.76). Further, HRs of gout with incident AMI were higher in patients without hypertension, diabetes mellitus, or hyperlipidemia (ranging from 1.63 to 2.09) than in those with each of these comorbidities (ranging from 0.95 to 1.13). The results of this study suggest that patients with gout have an increased risk of AMI. The AMI risk associated with gout was conditional on patients’ cardiovascular risk profile. Future work is needed to confirm these findings.

Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction

“…Besides the increased personal financial burden, direct and indirect annual financial burdens exist for those who cannot control gout well [ 3 ]. Patients with cardiovascular disease who have also been diagnosed with gout have higher mortality rates, regardless of age, sex, and comorbidities factors [ 4 ]. The mortality gap of gout, which is the association with premature death, has stayed consistent over 2 decades [ 5 , 6 ].…”

The risk of myocardial infarction and heart failure in patients with gouty arthritis: A systematic review and meta‐analysis

“…A total of 408 443 GA patients and 10 402 777 non‐GA patients were included in the meta‐analysis. The basic characteristics of the 11 selected cohort studies in the meta‐analysis are shown in Table 1 4,8–10,14,21–26 . All the studies were cohort studies, and the studies were published between 2006 and 2020.…”

“…The basic characteristics of the 11 selected cohort studies in the meta-analysis are shown in Table 1. 4,[8][9][10]14,[21][22][23][24][25][26] All the studies were cohort studies, and the studies were published between 2006 and 2020. There are 9 articles and 10 studies on the correlation between GA and MI risk, and there are 4 articles and 5 studies on the risk of GA and HF.…”

Cardiovascular Risks in Korean Patients with Gout: Analysis Using a National Health Insurance Service Database

“…However, whether gout itself is a risk factor for cardiovascular diseases and whether the risk of cardiovascular diseases is increased by comorbidities such as hypertension, diabetes, and hyperlipidemia remain controversial. Huang et al [8] have applied propensity score (PS) matching to answer this. Even after PS matching of comorbidities (i.e., hypertension, diabetes, hyperlipidemia, and CVD etc.…”