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Gout and the risk of acute myocardial infarction.
Arthritis Rheum. 2006 Aug; 54(8):2688-96.AR

Abstract

OBJECTIVE

To determine if hyperuricemia and gouty arthritis are independent risk factors for acute myocardial infarction (MI) and, if so, whether they are independent of renal function, diuretic use, metabolic syndrome, and other established risk factors.

METHODS

We performed multivariable logistic and instrumental variable probit regressions on data from the Multiple Risk Factor Intervention Trial (MRFIT).

RESULTS

Overall, there were 12,866 men in the MRFIT who were followed up for a mean of 6.5 years. There were 118 events of acute MI in the group with gout (10.5%) and 990 events in the group without gout (8.43%; P = 0.018). Hyperuricemia was an independent risk factor for acute MI in the multivariable regression models, with an odds ratio (OR) of 1.11 (95% confidence interval [95% CI] 1.08-1.15, P < 0.001). In multivariable regressions in which the above risk factors were used as covariates, gout was found to be associated with a higher risk of acute MI (OR 1.26 [95% CI 1.14-1.40], P < 0.001). Subgroup analyses showed that a relationship between gout and the risk of acute MI was present among nonusers of alcohol, diuretics, or aspirin and among those who did not have metabolic syndrome, diabetes mellitus, or obesity. In separate analyses, a relationship between gout and the risk of acute MI was evident among those with and without those hyperuricemia.

CONCLUSION

The independent risk relationship between hyperuricemia and acute MI is confirmed. Gouty arthritis is associated with an excess risk of acute MI, and this is not explained by its well-known links with renal function, metabolic syndrome, diuretic use, and traditional cardiovascular risk factors.

Authors+Show Affiliations

University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. Arthritis.MD@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16871533

Citation

Krishnan, Eswar, et al. "Gout and the Risk of Acute Myocardial Infarction." Arthritis and Rheumatism, vol. 54, no. 8, 2006, pp. 2688-96.
Krishnan E, Baker JF, Furst DE, et al. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006;54(8):2688-96.
Krishnan, E., Baker, J. F., Furst, D. E., & Schumacher, H. R. (2006). Gout and the risk of acute myocardial infarction. Arthritis and Rheumatism, 54(8), 2688-96.
Krishnan E, et al. Gout and the Risk of Acute Myocardial Infarction. Arthritis Rheum. 2006;54(8):2688-96. PubMed PMID: 16871533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gout and the risk of acute myocardial infarction. AU - Krishnan,Eswar, AU - Baker,Joshua F, AU - Furst,Daniel E, AU - Schumacher,H Ralph, PY - 2006/7/28/pubmed PY - 2006/9/20/medline PY - 2006/7/28/entrez SP - 2688 EP - 96 JF - Arthritis and rheumatism JO - Arthritis Rheum VL - 54 IS - 8 N2 - OBJECTIVE: To determine if hyperuricemia and gouty arthritis are independent risk factors for acute myocardial infarction (MI) and, if so, whether they are independent of renal function, diuretic use, metabolic syndrome, and other established risk factors. METHODS: We performed multivariable logistic and instrumental variable probit regressions on data from the Multiple Risk Factor Intervention Trial (MRFIT). RESULTS: Overall, there were 12,866 men in the MRFIT who were followed up for a mean of 6.5 years. There were 118 events of acute MI in the group with gout (10.5%) and 990 events in the group without gout (8.43%; P = 0.018). Hyperuricemia was an independent risk factor for acute MI in the multivariable regression models, with an odds ratio (OR) of 1.11 (95% confidence interval [95% CI] 1.08-1.15, P < 0.001). In multivariable regressions in which the above risk factors were used as covariates, gout was found to be associated with a higher risk of acute MI (OR 1.26 [95% CI 1.14-1.40], P < 0.001). Subgroup analyses showed that a relationship between gout and the risk of acute MI was present among nonusers of alcohol, diuretics, or aspirin and among those who did not have metabolic syndrome, diabetes mellitus, or obesity. In separate analyses, a relationship between gout and the risk of acute MI was evident among those with and without those hyperuricemia. CONCLUSION: The independent risk relationship between hyperuricemia and acute MI is confirmed. Gouty arthritis is associated with an excess risk of acute MI, and this is not explained by its well-known links with renal function, metabolic syndrome, diuretic use, and traditional cardiovascular risk factors. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/16871533/Gout_and_the_risk_of_acute_myocardial_infarction_ L2 - https://doi.org/10.1002/art.22014 DB - PRIME DP - Unbound Medicine ER -