Gout associated with doubled risk of death from heart failure

A clinical history of gout is associated with worse outcomes in patients with obstructive coronary artery disease (CAD), according to research published on Aug. 17 in the Journal of the American Heart Association.

The researchers, led by Neha J. Pagidipati, MD, MPH, of the Duke University School of Medicine in Durham, North Carolina, sought to assess the contemporary association between gout and cardiovascular disease in patients with obstructive CAD. Previous studies predate modern cardiovascular preventive therapy, the researchers noted.

Pagidipati and colleagues utilized data from the Duke Databank for Cardiovascular Diseases, which followed patients who underwent cardiac catheterization with obstructive CAD at Duke University Medical Center.

The final study cohort included more than 17,000 patients. A total of 1,406 patients exhibited gout at baseline and also exhibited cardiovascular risk factors for which they received high rates of “optimal” therapy.

Over an average follow-up time of six years, the researchers found gout was linked to worse cardiovascular outcomes and death. They found:

  • Patients who exhibited gout at any point of the study had double the risk of mortality due to heart failure, compared to those who never developed gout.
  • Patients who exhibited gout at any point of the study had a 15 percent higher chance of dying from cardiovascular disease, having a heart attack or stroke.

“Overall, these data suggest that, despite aggressive medical therapy, a clinical history of gout is associated with worse long-term cardiovascular clinical outcomes and all-cause mortality in patients with CAD,” the researchers wrote.

The authors noted that it is still unclear why gout increases the risk of cardiovascular disease or whether better control of the gout itself will improve cardiovascular outcomes. The association between gout and negative outcomes should be of special significance to clinicians because many patients do not realize such a link exists.

“From a physician’s perspective, it’s important to consider that patients with gout may be at increased risk for cardiovascular disease even if they’re already treating them with all the standard therapies. It’s something to have on their radar,” Pagidipati said in a prepared statement issued by the American Heart Association.