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A Danish cohort study examined patients with hyperuricemia and compared outcomes in those proven to have urate crystal deposition (317 patients) and matched 1:1 to patients without urate crystals. Interestingly, of the 80,726, 79,629 did not have uric acid crystal identification.
They found no difference between the two groups with regard to cardiovascular outcomes (hazard ratios = 0.86; 95 % confidence interval (CI) 0.52 - 1.43) or death (hazard ratio 0.74; CI 0.45 - 1.21). Hence, the presence of urate crystal precipitations does not to confer an added cardiovascular risk in hyperuricemic patients.