AB1053 CARDIOVASCULAR RISKS AND MORTALITY IN KOREAN PATIENTS WITH GOUT

Abstract

BackgroundGout is associated with an increased risk of cardiovascular comorbidities and premature mortality. Many epidemiologic studies support an association between gout and increased risk of diverse cardiovascular diseases. There has been no study on cardiovascular risks and mortality in Korean patients with gout with large scale data. Therefore, we intended to investigate the risk of each specific cardiovascular disease and mortality in Korean patient with gout with the national insurance database. The purpose of this study is to investigate cardiovascular risks and mortality in Korean patient with gout.ObjectivesThe purpose of this study is to investigate cardiovascular risks and mortality in Korean patient with gout.MethodsUsing Korean National Health Insurance Service data, we conducted a cohort study on gout patients. Gout patients were defined as those aged ≥ 20 years who were diagnosed as gout between 2009 and 2010, and control patients were matched with gout patients (1:1 ratio) after frequency matching for age, sex and index year. Primary outcomes were ischemic heart disease (IHD), acute myocardial infarction (AMI), congestive heart failure (CHF), cerebrovascular disease (CVD), cerebral infarction, cerebral hemorrhage, or transient ischemic attack (TIA). Secondary outcomes were all-cause mortality and cardiovascular mortality. We calculated hazard ratio (HR) in Cox regression, adjusting potential confounders.ResultsThis study included 3,306 gout patients and an equal number of matched controls. Multivariate Cox regression analysis showed that gout patients showed increased risks of IHD (HR 1.860, 95% CI 1.446-2.392), AMI (HR 3.246, 95% CI 1.460-7.217), CVD (HR 1.552, 95% CI 1.177-2.036) after adjusting age, sex, laboratory findings, comorbidities, and medication (Table 1). However, statistical differences were not found in the risks of CHF, cerebral infarction, cerebral hemorrhage, TIA, all-cause mortality, and cardiovascular mortality.Table 1.Multivariate Cox proportional HRs for cardiovascular risks of gout patientsOutcomeHR95% CIP-valueIschemic heart disease1.8601.446-2.392<0.001Acute myocardial infarction3.2461.460-7.2170.004Congestive heart failure1.3990.853-2.2950.183Cerebrovascular disease1.5521.177-2.0460.002Cerebral infarction1.0610.687-1.6370.790Cerebral hemorrhage0.7790.283-2.1450.629Transient ischemic attack1.2330.651-2.3360.521All-cause mortality1.1990.737-1.9520.465Cardiovascular mortality1.3770.452-4.1880.573HR, hazard ratio; CI, confidence interval.ConclusionOur study showed that cardiovascular risks of Korean patients with gout were increased, especially IHD, AMI and CVD.References[1]Kuo CF, See LC, Luo SF, Ko YS, Lin YS, et al. 2010. Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology (Oxford) 49:141-6[2]Kuo CF, Luo SF. 2017. Gout: Risk of premature death in gout unchanged for years. Nat Rev Rheumatol 13:200-1[3]Jung JH, Song GG, Ji JD, Lee YH, Kim JH, et al. 2018. Metabolic syndrome: prevalence and risk factors in Korean gout patients. Korean J Intern Med 33:815-22[4]Lee J, Lee JS, Park SH, Shin SA, Kim K. 2017. Cohort Profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol 46:e15[5]Huang CL, Wang TW, Chen YC, Hu JM, Ku PM, et al. 2021. Gout as a risk factor for acute myocardial infarction: evidence from competing risk model analysis. J Investig Med 69:1161-7[6]Krishnan E, Baker JF, Furst DE, Schumacher HR. 2006. Gout and the risk of acute myocardial infarction. Arthritis Rheum 54:2688-96[7]Liu SC, Xia L, Zhang J, Lu XH, Hu DK, et al. 2015. Gout and Risk of Myocardial Infarction: A Systematic Review and Meta-Analysis of Cohort Studies. PLoS One 10:e0134088Disclosure of InterestsNone declared