Gout Flares Up Cardiac Risks Save

A large case-control study showed that gout patients who experienced a cardiovascular (CV) event were more likely to have had a recent (< 120 days) gout flare compared to those without CV events.

This study sought to investigate the temporal association between gout flares and cardiovascular events in a gout cohort. 

Data was drawn from a retrospective analysis of electronic health records from the UK Clinical Practice Research Datalink (1997-2020). From a total of 62,574 gout patients there were 1421 patients with gout flare and cardiovascular event. Gout flares were ascertained using hospitalization, primary care outpatient, and prescription records. CV events included acute myocardial infarction or stroke. 

The 10 475 patients with gout and subsequent CV events were matched with 52 099 patients without CV events. Those with CV events (vs those witout) had:

• Greater odds of gout flare within the prior 0 to 60 days (2.0% vs 1.4%; adjusted OR 1.93; 95% CI, 1.57-2.38)
• Greater odds of gout flare within the prior 61 to 120 days (1.6% vs 1.2%; adj OR 1.57; 1.26-1.96).

Gout patients experiencing a CV event were more likely to have a gout "flare" preceding 120 days. These findings suggest gout flares are associated with a transient increase in CV events following the flare. This appeas to be mediated by heightened inflammation, as the results were similar when the analyses were repeated using only gout flares treated with NSAIDs, colchicine, or steroids.