title: Acute gouty arthritis complicated with acute ST elevation myocardial infarction is independently associated with short- and long-term adverse non-fatal cardiac events.
abstract: Large epidemiologic studies have associated gouty arthritis with the risk of coronary heart disease. However, there has been a lack of information regarding the outcomes for patients who have gout attacks during hospitalization for acute myocardial infarction. We reviewed the data of 444 consecutive patients who were admitted to our hospital between 2005 and 2008 due to acute ST elevation myocardial infarction (STEMI). The clinical outcomes were compared between patients with gout attack and those without. Of the 444, 48 patients with acute STEMI developed acute gouty arthritis during hospitalization. The multivariate analysis identified prior history of gout and estimated glomerular filtration rate as independent risk factors of gout attack for patients with acute STEMI (odds ratio (OR) 21.02, 95 % CI 2.96-149.26, p = 0.002; OR 0.92, 95 % CI 0.86-0.99, p = 0.035, respectively). The in-hospital mortality and duration of hospital stay did not differ significantly between the gouty group and the non-gouty group (controls). During a mean follow-up of 49 ± 28 months, all-cause mortality and stroke were similar for both groups. Multivariate Cox regression showed that gout attack was independently associated with short- and long-term adverse non-fatal cardiac events (hazard ratio (HR) 1.88, 95 % CI 1.09-3.24, p = 0.024; HR 1.82, 95 % CI 1.09-3.03, p = 0.022, respectively). Gout attack among patients hospitalized due to acute STEMI was independently associated with short-term and long-term rates of adverse non-fatal cardiac events.
authors.affiliation: First Cardiovascular Division, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 199, Tung-Hwa North Road, Taipei, Taiwan.
authors.forename: Kuan-Liang
authors.initials: KL
authors.lastname: Liu
authors.forename: Hsin-Fu
authors.initials: HF
authors.lastname: Lee
authors.forename: Shing-Hsien
authors.initials: SH
authors.lastname: Chou
authors.forename: Yen-Chen
authors.initials: YC
authors.lastname: Lin
authors.forename: Chia-Pin
authors.initials: CP
authors.lastname: Lin
authors.forename: Chun-Li
authors.initials: CL
authors.lastname: Wang
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Lung-An
authors.initials: LA
authors.lastname: Hsu
mesh_terms: D000368:Aged; D015210:Arthritis, Gouty / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005919:Glomerular Filtration Rate; D006331:Heart Diseases / Q000150:complications / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome