title: Effect of Urate-Lowering Therapy on All-Cause and Cardiovascular Mortality in Hyperuricemic Patients without Gout: A Case-Matched Cohort Study.
abstract: OBJECTIVE
  An increased risk of mortality in patients with hyperuricemia has been reported. We examined (1) the risk of all-cause and cardiovascular disease (CVD) mortality in untreated hyperuricemic patients who did not receive urate-lowering therapy (ULT), and (2) the impact of ULT on mortality risk in patients with hyperuricemia.
  
  
  METHODS
  In this retrospective case-matched cohort study during a mean follow-up of 6.4 years, 40,118 Taiwanese individuals aged ≥17 years who had never used ULT and who had never had gout were examined. The mortality rate was compared between 3,088 hyperuricemic patients who did not receive ULT and reference subjects (no hyperuricemia, no gout, no ULT) matched for age and sex (1:3 hyperuricemic patients/reference subjects), and between 1,024 hyperuricemic patients who received ULT and 1,024 hyperuricemic patients who did not receive ULT (matched 1:1 based on their propensity score and the index date of ULT prescription). Cox proportional hazard modeling was used to estimate the respective risk of all-cause and CVD (ICD-9 code 390-459) mortality.
  
  
  RESULTS
  After adjustment, hyperuricemic patients who did not receive ULT had increased risks of all-cause (hazard ratio, 1.24; 95% confidence interval, 0.97-1.59) and CVD (2.13; 1.34-3.39) mortality relative to the matched reference subjects. Hyperuricemic patients treated with ULT had a lower risk of all-cause death (0.60; 0.41-0.88) relative to hyperuricemic patients who did not receive ULT.
  
  
  CONCLUSIONS
  Under-treatment of hyperuricemia has serious negative consequences. Hyperuricemic patients who received ULT had potentially better survival than patients who did not.
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan.|Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Jiunn-Horng
authors.initials: JH
authors.lastname: Chen
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan.|Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Joung-Liang
authors.initials: JL
authors.lastname: Lan
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan.|Graduate Institute of Biostatistics, Biostatistics Center, China Medical University, Taichung, Taiwan.
authors.forename: Chi-Fung
authors.initials: CF
authors.lastname: Cheng
authors.affiliation: Department of Public Health, China Medical University, Taichung, Taiwan.|Graduate Institute of Biostatistics, Biostatistics Center, China Medical University, Taichung, Taiwan.
authors.forename: Wen-Miin
authors.initials: WM
authors.lastname: Liang
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Internal Medicine, Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hsiao-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan.|Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Tsay
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
authors.forename: Wen-Ting
authors.initials: WT
authors.lastname: Yeh
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.|Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
authors.forename: Wen-Harn
authors.initials: WH
authors.lastname: Pan
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D006074:Gout Suppressants