Risk of Major Adverse Cardiovascular Event Following Incident Hospitalization for Acute Gout: A Western Australian Population‐Level Linked Data Study

Author:

Lopez Derrick1ORCID,Dwivedi Girish2ORCID,Nossent Johannes3ORCID,Preen David B.1ORCID,Murray Kevin1ORCID,Raymond Warren1ORCID,Inderjeeth Charles3ORCID,Keen Helen I.4ORCID

Affiliation:

1. The University of Western Australia Crawley Western Australia Australia

2. The University of Western Australia, Crawley, Fiona Stanley Hospital, Murdoch, and Harry Perkins Institute of Medical Research Western Australia Australia

3. The University of Western Australia, Crawley, and Sir Charles Gairdner Hospital Nedlands Western Australia Australia

4. The University of Western Australia, Crawley, and Fiona Stanley Hospital Murdoch Western Australia Australia

Abstract

BackgroundCardiovascular disease is the most common cause of death in people with gout. Acute inflammation, which is a characteristic of gout, may have a mechanistic role in major adverse cardiovascular events (MACEs). We aimed to examine the relationship between admissions to a hospital with acute gout and MACEs in a large population‐based data set.MethodsWe extracted data from the Hospital Morbidity Data Collection and Death Registrations of the Western Australian Rheumatic Disease Epidemiology Registry. We identified patients admitted to hospital with incident acute gout and who had admissions or a death record because of MACEs. We compared the risk of MACEs during the postdischarge period (1‐30 days after acute gout admission) and control period (365 days prior to admission and 365 days after the postdischarge period) using a self‐controlled case‐series (SCCS) design, which is a within‐person design that controls for time‐invariant patient‐specific confounding. We performed conditional fixed‐effects Poisson regression to obtain rate ratios (RRs).ResultsWe identified 941 patients (average age: 76.4 years; SD: 12.6; 66.7% male) with an incident acute gout admission and documented MACEs during the control and/or postdischarge periods. Of the 941 patients, 898 (95%) experienced MACEs during the combined control period (730‐day period) and 112 (12%) during the postdischarge period (30‐day period). The rates of MACEs during the total control and postdischarge periods were 0.84 and 1.45 events per person‐year, respectively. Regression analysis confirmed increased rate during the postdischarge period (RR: 1.67; 95% CI: 1.38‐2.03) compared with the control period. Sensitivity analyses indicated that our results were robust in relation to known limitations of the SCCS design.ConclusionWe report an increased risk of MACEs in the first 30 days after an incident hospital admission with acute gout, suggesting a temporal association between acute inflammation and subsequent MACEs in patients with gout.

Funder

Arthritis Australia

Publisher

Wiley

Subject

Rheumatology

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