Ab0635 evaluation of the Intima-Media Thickness Index by Carotid Doppler in Patients With Monosodium Urate Deposition Arthritis of the Hospital Docente Padre Billini, Dominican Republic

Abstract

Background:Hyperuricemia and gout are risk factors for atherosclerosis subclinical and cardiovascular complications. (1) However, it is still debated whether uric acid is an independent predictor of cardiovascular risk. (2) Vascular Doppler and in particular the measurement of the intima-media thickness and the detection of plaques are useful in the evaluation of cerebrovascular disease and cardiovascular risk. (3) An intima-media thickness greater than 0.9 mm and / or the presence of atheromatous plaques in the carotid are predictive of high cardiovascular risk and silent heart disease. (4) Gouty arthritis has been associated with alteration of the carotid intima media thickness (cIMT) and subclinical atherosclerosis. Cukurova et al studied patients with gout, finding an increase in cIMT compared to patients with asymptomatic hyperuricemia. (5)Objectives:Assess the carotid intima-media thickness in patients with monosodium urate deposits arthritisMethods:Prospective, observational, cross-sectional study. Carotid Doppler was performed on patients in the outpatient clinic with a diagnosis of gout from November 2019 to 2020 of the rheumatology service of the Hospital Docente Padre Billini and healthy controls. Inclusion criteria, patients> 18 years, diagnosis of monosodium urate deposits arthritis according to the ACR / EULAR 2015 classification criteria, carotid Doppler, measurement of the cIMT. Controls without disease, matched by sex and age. The data was analyzed with SPSS V23 for Windows 10.Results:Of 37 patients with a diagnosis of arthritis due to deposition of monosodium urate crystals, (34) met inclusion criteria, 100% male, 34 healthy controls. Average of 61.5 years. Average of the disease 8.2 years. Distribution 61% (21) intercritical gout, 32% (11) chronic tophaceous gout, 0.5% (2) acute gouty arthritis. Comorbidities 67% (23) dyslipidemia, 35% (12) hyperglycemia. 26% (9) presented arterial hypertension. 20% (7) have diabetes mellitus. 58% (20) are alcohol drinkers, 11% (4) smokers. Mean uric acid 8.6 mg / dl at Doppler, 52% (18) elevated serum creatinine. Carotid Doppler in patients with gout showed a 55% (19) increase in the cIMT > 0.9mm, with a mean of 2.03mm (1.95 SD). Carotid Doppler in healthy controls 17% (6) increased cIMT, mean of 1.8mm (2.2 SD) (P = 0.040). Patients with gout had 29% (10) atheromatous plaques, 17% (6) calcified plaques versus 14% (5) atheromatous plaques, 8% (3) calcified in healthy controls.Conclusion:Our study showed that half of the patients with gout had increased cIMT compared to a third of the healthy controls. The presence of atheromatous and calcified plaques was mainly associated with dyslipidemia, so we can conclude that the evaluation of the intima-media thickness by carotid Doppler allows it to be a predictor of cardiovascular disease in patients with gout.References:[1]Choi HK, Curhan G (2007) Independent impact of gout on mortality and risk for coronary heart disease. Circulation 116:894–900[2]Feig DI, Kang DH, Johnson RJ (2008) Uric acid and cardiovascular risk. N Engl J Med 359:1811–1821[3]Choi, HK. Rho, Y-H., Zhu, Y., Cea-Soriano, L., Aviña-Zubieta, JA. Zhang, Y. The risk of pulmonary embolism and deep vein thrombosis in rheumatoid arthritis: A UK population-based outpatient cohort study. Ann Rheum Dis. 2013; 72 (7): 1182-7[4]Gkaliagkousi, E., Gavriilaki, E., Doumas, M., Petidis, K., Aslanidis, S., Stella, D. Cardiovascular risk in rheumatoid arthritis: Pathogenesis, diagnosis, and management. J ClinRheumatolPract Rep Rheum Musculoskelet Dis. 2012; 18 (8): 422-30[5]Cukurova S, Pamuk ÖN, Ünlü E, Pamuk GE, C¸ akir N. Subclinical atherosclerosis in gouty arthritis patients: a comparative study. Rheumatol Int. 2012; 32(6):1769–73.Disclosure of Interests:None declared.