Gout and non-cardiovascular related mortality

  • Vargas-Santos AB & al.
  • 6 Jun 2019

  • Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Gout was associated with an increased risk for all-cause and cause-specific mortality, particularly in those with renal disease, disease of the digestive system and infection.

Why this matters

  • Findings highlight the importance of comorbidities other than cardiovascular (CV) diseases in the management of gout.

Study design

  • This study included 19,497 participants with newly diagnosed gout (32% women) and 194,947 age- and sex-matched participants without gout.
  • Main outcomes: all-cause and cause-specific (renal disease, dementia, infection, diabetes, disease of the digestive system, lung disease, neoplasm and others) mortality.
  • Funding: None disclosed.

Key results

  • Patients with gout had higher prevalence of chronic kidney disease, metabolic and CV comorbidities.
  • Patients with gout vs those without were at an increased risk for all-cause mortality (HR, 1.17; 95% CI, 1.14-1.21), and the risk was higher in women (HR, 1.23; 95% CI, 1.17-1.30) than men (HR, 1.15; 95% CI, 1.10-1.19).
  • For cause-specific mortality, patients with gout vs those without were at an increased risk for mortality due to:
    • renal disease (HR, 1.78; 95% CI, 1.34-2.35),
    • diseases of digestive system (HR, 1.56; 95% CI, 1.34-1.83),
    • CV diseases (HR, 1.27; 95% CI, 1.22-1.33),
    • infections (HR, 1.20; 95% CI, 1.06-1.35), and
    • dementia (HR, 0.83; 95% CI, 0.72-0.97).
  • The risk for dementia-related mortality was lower in patients with gout vs those without (HR, 0.83; 95% CI, 0.72-0.97).

Limitations

  • Possibility of diagnosis misclassification.
  • Risk of residual confounding.