Original Article

Diagnosis of Gout as a Correlative Risk for Acute Myocardial Infarction in the Absence of Traditional Cardiovascular Risk Factors

Authors: Rezwan F. Munshi, MD, James R. Pellegrini, MD, Samuel Olson, BS, Andrej M. Sodoma, DO, Prachi Anand, MD, Ofek Hai, MD, Roman Zeltser, MD, Amgad N. Makaryus, MD

Abstract

Objectives: We aimed to study the impact of gout as a correlative risk factor in the incidence of acute myocardial infarction (AMI) among patients without known MI risk factors. Our study population was obtained from the National Inpatient Sample (NIS) 2011–2018 using the International Classification of Diseases, Ninth and Tenth Revisions.

Methods: This study included patients without cardiovascular disease (CVD), and various outcomes were compared among patients with and without gout. Cohorts were weighted using an algorithm provided by the NIS, which allows for national estimates. Our primary endpoint was the odds of developing an MI, and secondary endpoints were adverse hospital events and length of stay. In total, 117,261,842 patients without CVD risk factors were included in this study, 187,619 (0.16%) of whom had a diagnosis of gout.

Results: Patients without CVD risk factors who had gout were older and more likely to be male compared with patients without gout. Among patients without CVD risk factors, the odds of having an AMI were significantly higher in those with gout compared with those without, even after adjusting for chronic nonsteroidal anti-inflammatory drug and oral steroid use. Moreover, patients without CVD risk factors and with gout were more likely to develop acute renal failure, acute thromboembolic event, shock, acute gastrointestinal bleed, and arrhythmia compared with those without gout. Furthermore, patients without CVD risk factors who were admitted with gout had higher mortality compared with those without gout.

Conclusions: In our study, we found that patients without risk factors for AMI who had gout were more likely to develop AMI compared with those without gout. Furthermore, the same patients were more likely to develop other adverse outcomes. Even with proper management, these individuals should be monitored closely for coronary events.
Posted in: Rheumatology and Orthopedics26

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