Gout & Heart Disease

http://www.gout-pal.com/gout/2007/04/ has 2 reports, one of which is unreliable for linking.

Best to split this into two GoutPal.com Gout Research pages, then link to those.

First report is (Gout & Heart Disease)

Arthritis Rheum. 2006 Aug;54(8):2688-96.Click here to read Links
Gout and the risk of acute myocardial infarction.
Krishnan E, Baker JF, Furst DE, Schumacher HR.

University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.

OBJECTIVE: To determine if hyperuricemia and gouty arthritis are independent risk factors for acute myocardial infarction (MI) and, if so, whether they are independent of renal function, diuretic use, metabolic syndrome, and other established risk factors. METHODS: We performed multivariable logistic and instrumental variable probit regressions on data from the Multiple Risk Factor Intervention Trial (MRFIT). RESULTS: Overall, there were 12,866 men in the MRFIT who were followed up for a mean of 6.5 years. There were 118 events of acute MI in the group with gout (10.5%) and 990 events in the group without gout (8.43%; P = 0.018). Hyperuricemia was an independent risk factor for acute MI in the multivariable regression models, with an odds ratio (OR) of 1.11 (95% confidence interval [95% CI] 1.08-1.15, P < 0.001). In multivariable regressions in which the above risk factors were used as covariates, gout was found to be associated with a higher risk of acute MI (OR 1.26 [95% CI 1.14-1.40], P < 0.001). Subgroup analyses showed that a relationship between gout and the risk of acute MI was present among nonusers of alcohol, diuretics, or aspirin and among those who did not have metabolic syndrome, diabetes mellitus, or obesity. In separate analyses, a relationship between gout and the risk of acute MI was evident among those with and without those hyperuricemia. CONCLUSION: The independent risk relationship between hyperuricemia and acute MI is confirmed. Gouty arthritis is associated with an excess risk of acute MI, and this is not explained by its well-known links with renal function, metabolic syndrome, diuretic use, and traditional cardiovascular risk factors.

PMID: 16871533 [PubMed - indexed for MEDLINE]

Only add hyperuricemia and diuretic to Gout Dictionary. Other terms are either statistical, heart, or general medical terms that can be explained in the article:
acute MI, metabolic syndrome

This also shows a related article:
Long-term Cardiovascular Mortality Among Middle-aged Men With Gout

Eswar Krishnan, MD, MPH; Kenneth Svendsen, MS; James D. Neaton, PhD; Greg Grandits, MS; Lewis H. Kuller, MD; for the MRFIT Research Group

Arch Intern Med. 2008;168(10):1104-1110.

Background There are limited data available on the association of gouty arthritis (gout) in middle age with long-term cardiovascular disease (CVD) mortality.

Methods We performed a 17-year follow-up study of 9105 men, aged 41 to 63 years and at above-average risk for coronary heart disease, who were randomized to the Multiple Risk Factor Intervention Trial and who did not die or have clinical or electrocardiographic evidence of coronary artery disease during the 6-year trial. Risk of CVD death and other causes subsequent to the sixth annual examination associated with gout was assessed by means of Cox proportional hazards regressions.

Results The unadjusted mortality rates from CVD among those with and without gout were 10.3 per 1000 person-years and 8.0 per 1000 person-years, respectively, representing an approximately 30% greater risk. After adjustment for traditional risk factors, use of diuretics and aspirin, and serum creatinine level, the hazard ratio (gout vs no gout) for coronary heart disease mortality was 1.35 (95% confidence interval [CI], 1.06-1.72). The hazard ratio for death from myocardial infarction was 1.35 (95% CI, 0.94-1.93); for death from CVD overall, 1.21 (95% CI, 0.99-1.49); and for death from any cause, 1.09 (95% CI, 1.00-1.19) (P = .04). The association between hyperuricemia and CVD was weak and did not persist when analysis was limited to men with hyperuricemia without a diagnosis of gout.

Conclusion Among middle-aged men, a diagnosis of gout accompanied by an elevated uric acid level imparts significant independent CVD mortality risk.

Trial Registration clinicaltrials.gov Identifier: NCT00000487

2nd report is (Uric Acid & Heart Disease)

The second report abstract from PubMed is:
Tohoku J Exp Med. 2007 Apr;211(4):369-77.Click here to read Links
Independent association of high serum uric acid concentration with angiographically defined coronary artery disease.
Jelić-Ivanović Z, Memon L, Spasojević-Kalimanovska V, Bogavac-Stanojević N, Spasić S.

Institute of Medical Biochemistry, Belgrade, Serbia.

Epidemiological studies have shown that a high serum uric acid concentration is a risk factor for coronary artery disease (CAD). However, the issue of whether it is an independent cardiovascular risk factor or simply a marker of co-existing conditions is a matter of controversy. In the present case-controlled study, we explored the association between serum uric acid and angiographically defined CAD in middle-aged subjects (356 CAD patients and 350 healthy individuals). Serum uric acid in CAD patients was significantly higher than that in healthy individuals (359 +/- 88.7 and 289 +/- 79.3 micromol/l, respectively, p < 0.01) and remained significantly higher after adjusting for confounding factors (F = 79.77, p < 0.01). The association between uric acid and CAD was not limited to the hyperuricemic range of values, but was also found in the high-normal range (p < 0.01). An unadjusted odds ratio (OR) of 5.0 was obtained in both genders (p 50% stenosis (clinically significant CAD), regardless of the number of diseased vessels, had higher uric acid concentrations than those with < 50% stenosis even after adjusting for confounders (F = 3.79, p = 0.01). In conclusion, we have demonstrated that high serum uric acid is independently associated with CAD and that uric acid determination could be useful as one of the markers of clinically significant CAD.

PMID: 17409677 [PubMed - indexed for MEDLINE]

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