Gout was not found to be associated with increased risk for cardiovascular complications in patients with peripheral artery disease (PAD), according to the results of a multi-center prospective cohort study published in Atherosclerosis.
Patients (n=4308) were recruited from 4 outpatient clinics beginning in 2002. All participants had been diagnosed with PAD by a vascular specialist. Gout was diagnosed based on the International Classification of Disease 9 or 10 criteria. Patients were assessed for major adverse cardiovascular events and mortality.
In total, 43.2% of participants had comorbid abdominal aortic or peripheral aneurysm, 23.6% had intermittent claudication, 21.9% had carotid artery stenosis, 11.3% had critical limb ischemia, and 7.8% of had gout.
At baseline, patients with vs without gout (n=334 and n=3974, respectively) differed in: median age (73 vs 70 years, respectively; P <.001), male gender (88.6% vs 74.4%, respectively; P <.001), rate of hypertension (53.9% vs 75.0%, respectively; P <.001), rate of coronary heart disease (53.9% vs 46.4%, respectively; P =.008), percentage of participants on statin therapy (74.3% vs 68.9%, respectively; P =.040), and median estimated glomerular filtration rate (65 vs 76 mL/min/1.73m2, respectively; P <.001). After propensity matching, the difference between patients with vs without gout (n=334 and n=299, respectively) remained for estimated glomerular filtration rate (65 vs 71 mL/min/1.73m2, respectively; P =.023).
In the entire cohort, patients with vs without gout were at greater risk for major cardiovascular events (hazard ratio [HR], 1.37; 95% CI, 1.09-1.71; P =.006) and mortality (HR, 1.38; 95% CI, 1.13-1.68; P =.002). However, in the propensity-matched cohort, this difference was not observed (cardiovascular complication: HR, 1.06; 95% CI, 0.78-1.44; P =.717 and mortality: HR, 1.06; 95% CI, 0.81-1.39; P =.681).
A major limitation of this study was that patients were not stratified according to PAD type.
“The results [of this study] do not suggest an independent association between gout and cardiovascular events amongst individuals with PAD,” concluded the study authors.
Singh T P, Wong S, Quigley F, et al. Association of gout with major adverse cardiovascular events and all-cause mortality in patients with peripheral artery disease. Atherosclerosis. 2020;312:23-27. doi:10.1016/j.atherosclerosis.2020.08.029