AB1263 REGIONAL VARIATIONS OF CARDIOVASCULAR RISK IN GOUT PATIENTS: A NATIONWIDE COHORT STUDY IN KOREA

Background

Gout is also closely associated with systemic disorders and cardiovascular (CV) risk profiles, such as hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, alcohol consumption, and obesity.[1] In addition, gout has been suggested as a cause of CV diseases via pathogenic mechanisms such as endothelial dysfunction, oxidative metabolism, platelet adhesiveness, and aggregation. [2-4] Accordingly, several epidemiological studies reported that patients with gout had an increased risk for CV events. [3, 4] In particular, differences in population characteristics between urban regions and other regions are getting more significant owing to recent rapid industrialization. Accordingly, a study on regional differences should be conducted; however, there are still few studies on it.

Objectives

We aimed to investigate the risk of major cardiovascular events in gout patients in different regions.

Methods

This was a nationwide cohort study based on the claims database of the Korean National Health Insurance and the National Health Screening Program. Patients aged 20 to 90 years newly diagnosed with gout after January 2012 were included. After cardiovascular risk profiles before gout diagnosis were adjusted, the relative risks of incident cardiovascular events (myocardial infarction, cerebral infarction, and cerebral hemorrhage) in gout patients in different regions were assessed.

Results

In total, 231,668 patients with gout were studied. Regional differences in cardiovascular risk profiles before the diagnosis were observed. Multivariable analysis showed that patients with gout in Jeolla/Gwangju had a significantly high risk of myocardial infarction (adjusted hazard ratio [aHR] 1.27 [95% confidence interval [CI], 1.02–1.56], P = 0.03). In addition, patients with gout in Gangwon (aHR 1.38 [95% CI, 1.09–1.74], P = 0.01), Jeolla/Gwangju (aHR 1.41 [95% CI, 1.19–1.67], P < 0.01), and Gyeongsang/Busan/Daegu/Ulsan (aHR 1.37 [95% CI, 1.19–1.59], P < 0.01) had a significantly high risk of cerebral infarction.

Conclusion

We found there were regional differences in cardiovascular risk and associated risk factors in gout patients. Physicians should screen gout patients for cardiovascular risk profiles in order to facilitate prompt diagnosis and treatment.

References

[1]Zhu Y, Pandya BJ, Choi HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007-2008. Am J Med. 2012;125(7):679-87.e1. [2]Kang DH, Nakagawa T, Feng L, Watanabe S, Han L, Mazzali M, et al. A role for uric acid in the progression of renal disease. J Am Soc Nephrol. 2002;13(12):2888-97. [3]Seminog OO, Goldacre MJ. Gout as a risk factor for myocardial infarction and stroke in England: evidence from record linkage studies. Rheumatology (Oxford). 2013;52(12):2251-9. [4]Abbott RD, Brand FN, Kannel WB, Castelli WP. Gout and coronary heart disease: the Framingham Study. Journal of clinical epidemiology. 1988;41(3):237-42.

Acknowledgements:

NIL.

Disclosure of Interests

None Declared.