The risk and severity of stroke in patients with atrial fibrillation and gout: A National Representative Database study

Abstract

Background It has been shown that gout is associated with left atrium remodeling and a pro‐inflammatory state leading to the development of atrial fibrillation (AF). There is limited evidence whether gout increases the risk of stroke in patients with AF. We assessed the incidence of gout and the risk of stroke in patients with AF. Methods This is a retrospective cohort study using the 2016 US National Inpatient Sample (NIS) based on ICD‐10 codes. The outcomes of the study were the risk and severity of new stroke in patients with pre‐existing AF and gout. Results In 2016, we identified 3 844 057 patients admitted to the hospitals in NIS with history of AF, of which 240 875 had history of gout. Patients with AF and gout have higher risk of new stroke (OR 2.07 [1.97‐2.19], P < .001), and this risk remains significantly elevated after adjusting for CHADS2VASC score variables, chronic kidney disease, dyslipidemia, obesity, and race (OR 1.10 [1.01‐1.11], P = .041). However, presence of gout in patients with AF was not associated with all‐cause in‐hospital mortality, need for mechanical ventilation, percutaneous gastrostomy tube insertion, or discharge to skilled nursing facility. Conclusion Subjects with AF and gout compared to AF alone had an increased risk of new stroke, but presence of gout was not associated with stroke severity. There is a potential role of gout as a risk factor or a risk marker for stroke in subjects with AF.

Gout and Cardiovascular Disease: Mechanisms, Risk Estimations, and the Impact of Therapies

“…Accordingly, gout must be considered an independent cardiovascular risk factor-indicating that patients with gout have a heightened cardiovascular risk merely from suffering the condition. The risk associated with gout has been demonstrated for all forms of atherosclerotic CVD and their derived mortality rates [15,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44], as shown in Table 1. In this sense, aggregate data show that the risk of gout patients dying due to CVD is 1.29-fold higher, and up to 1.42-fold higher for coronary disease-related deaths [36].…”

Monocyte to high-density lipoprotein cholesterol ratio and serum uric acid in Chinese adults: a cross-sectional study

“…MSU accumulation can lead to local inflammation and tissue damage, which eventually leads to the onset of gout or gouty kidney. Hyperuricemia and gout are associated with morbidity and poor prognoses in chronic kidney disease [ 1 – 3 ], cardiovascular disease [ 2 , 4 ], diabetes [ 2 ], atrial fibrillation [ 5 ], stroke [ 6 ], and dyslipidemia [ 2 ]. Monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR), a new predictive marker of inflammation, indicates the ratio of inflammatory markers (monocytes) to anti-inflammatory markers (HDL-C) [ 7 ].…”

Detection and Quantification of the Relationship between the Ratio of Triglycerides over High-Density Lipoprotein Cholesterol and the Level of Serum Uric Acid: One Cross-Sectional Study

“…As the synthesis and catabolic excretion of uric acid become imbalanced, uric acid accumulates inside, and this eventually leads to hyperuricemia. Hyperuricemia predisposes individuals to uric acid nephropathy, gouty arthritis, and urolithiasis and may also increase the risk of diabetes [5], atrial brillation [6], stroke [7], and cardiovascular disease [5,8]. As a novel in ammatory marker that has received much attention during the last years, the ratio of triglycerides to high-density lipoprotein cholesterol (TG/ HDL-C) is considered to be associated with cardiovascular disease [9], stroke [10], atherosclerosis [11], and insulin resistance risk [12].…”