Ten-year cardiovascular risk changes and major adverse events in gout patients.

Abstract

The long-term interaction between cardiovascular (CV) risk profiles and gout may influence the risk of cardiovascular events. However, the impact of gout and long-term changes in CV risk profile on CV events is unclear. This was a nationwide cohort study based on the Korean National Health Insurance claims database and the National Health Screening Program. Patients aged 20-90 years newly diagnosed with gout after January 2012 and age- and sex-matched controls without gout were included. After adjusting for CV risk profiles measured 10 years before gout diagnosis and their long-term changes, the relative risks of incident CV events (myocardial infarction, cerebral infarction and cerebral haemorrhage) and all-cause death in the gout patients were assessed. In total, 113 853 patients with gout and 1 138 530 matched controls were studied. Multivariable analysis showed that gout was associated with increased risks for myocardial infarction (hazard ratio [HR]: 1.39, P < 0.001), cerebral infarction (HR: 1.36, P < 0.001), cerebral haemorrhage (HR: 1.50, P < 0.001), and all-cause death (HR: 1.07, P = 0.004). In addition, significant interactions were observed for myocardial infarction (Grade 1 aggravation over 10 years of diastolic blood pressure [DBP], P = 0.042), cerebral infarction (Grade 2 aggravation over 10 years of DBP, P = 0.037) and cerebral haemorrhage (Grade 2 aggravation over 10 years of total cholesterol, P = 0.057). Gout patients had a high risk of incident CV events even after adjusting for CV risk profiles and their long-term changes. These long-term changes additively increase the risk of CV events in gout patients.