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Gout Increases Risk of Stroke Moreso than MI

Gout coassociates with many of the disorders within the metabolic syndrome - diabetes, hypertension, hyperlipidemia and obesity.  Not surprisingly, gout is a risk factor for cardiovascular disease, but the risk magnitude for  myocardial infarction (MI), and stroke are unclear.

Singh and colleagues used U.S. claims data from 2007 to 2010 to study four specific cohorts: (1) DM only (n=232,592), (2) gout only (71,755), (3) gout and DM (23,261)and (4) neither gout nor DM (1,010,893) and were assesessed for furure acute MI or stroke with hospitalization.

The incidence of acute MI was lowest in patients with neither gout nor DM, followed by patients with gout alone, DM alone, and both.

Results were more striking in the elderly such that men >80 years of age had incidence rates/1000 person-years of  14.6, 25.4, 27.7, and 37.4 for DM, Gout, both Gout and DM, neither, respectively. Similar trends were noted for stroke and in women.

Compared with DM only, gout had a significantly lower adjusted HR of incident MI (HR 0.81), but a similar risk of stroke (HR 1.02).

Having both gout and DM resulted in a significantly higher risk of incident MI (HR 1.35) and stroke  (HR 1.42) compared with DM only patients.

This report shows gout to yield a stroke risk equal to DM.  But the same can not be said for incident MI where DM augment MI risk moreso than gout. Having both gout and DM confers incremental risk compared with DM alone for both incident MI and stroke.

The author has no conflicts of interest to disclose related to this subject

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