Gout and Risk of Myocardial Infarction: A Systematic Review and Meta-Analysis of Cohort Studies

Abstract

IntroductionA high incidence of myocardial infarction among patients with gout has been suggested by several observational studies. We performed a meta-analysis to evaluate the association between gout and the risk of myocardial infarction.Materials and MethodsThe PubMed and Embase databases were searched from inception to October 2014 for cohort studies that evaluating the association between gout and the risk of myocardial infarction. Summary estimates were derived using a random-effects model and reported as relative risks (RRs) with 95% confidence intervals (CIs).ResultsFive studies involving 8,656,413 participants with a total of 1000 MI events were included. Overall, gout was associated with an increased risk of myocardial infarction (RR 1.45; 95% CI, 1.19–1.75; p<0.001), and the association referred to non-fatal myocardial infarction (RR 1.29; 95% CI, 1.19–1.39; p <0.001) but not fatal myocardial infarction (RR 1.11; 95% CI, 0.96–1.28; p = 0.174). The increased risk was observed in both women (RR 1.62; 95% CI, 1.18–2.21; p = 0.003) and men (RR 1.45; 95% CI, 1.21–1.74; p <0.001). Stratified analysis revealed a gradual increase in myocardial infarction risk with a younger age of gout onset (age 20–44 years old (RR 2.82; 95% CI, 1.38–5.79; p = 0.05); 45–69 years old (RR 1.85; 95% CI, 1.22–2.82; p = 0.04); ≥70 years old (RR 1.52; 95% CI, 1.22–1.88; p <0.001)).ConclusionThis meta-analysis suggests that patients with gout have an increased risk of myocardial infarction.

Epidemiology and health-related services

“…Nevertheless, several recent studies have once again linked gout with cardiovascular outcomes [54], cardiovascular mortality [55], and myocardial infarction [56]. Interestingly, cardiovascular outcomes have been considered to be the main determinants of costs in gout [57].…”

Gouty Offense in Patients With Obstructive Coronary Artery Disease Despite State‐of‐the‐Art Therapy

“…Because CVD and coronary heart disease/CAD comprise slightly different diseases and none of the studies described above gave details on the specific type of coronary heart disease, it would have been very interesting to differentially display the data presented by Pagidipati et al for sex and race since ≈300 individuals with a gout history included in this study were women and/or of nonwhite background. Association between MI and gout is less clear7; however, recent studies and meta‐analysis suggest a correlation of gout and the risk for nonfatal MI in both sexes,13, 14, 15 a finding not supported by data from Pagidipati et al 4. Yet, comparison between different studies in general has to be viewed with caution.…”

Metal-Assisted and Microwave-Accelerated Decrystallization

“…Intensive pharmacological treatment of the disorder [10]. NSAIDs are commonly used for the treatment of arthritis but are linked to increased risk of the development of congestive heart failure [11,12]. Olchicine, though used for the treatment of goutassociated pain during the early onset of an attack, is comparable in toxicity to arsenic and is blamed for muscle damage, neuropathy, and multiple organ failure [13,14].…”