Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Feb 15;2(1):e000282.
doi: 10.1136/bmjopen-2011-000282. Print 2012.

Gout and the risk for incident heart failure and systolic dysfunction

Eswar Krishnan  1
Affiliations

Gout and the risk for incident heart failure and systolic dysfunction

Eswar Krishnan. BMJ Open. .

Abstract

Objective: To test the hypothesis that gouty arthritis (gout) is a risk factor for incidence of heart failure and for echocardiographic measures signifying subclinical heart failure.

Design: Post-hoc, longitudinal and cross-sectional analyses of a prospective cohort study where data were collected in 4-year intervals since 1971.

Settings: The population-based Framingham Offspring Study.

Participants: 4989 adults (mean age 36 years, 52% women) free of clinical heart failure at baseline.

Outcome measures: Incident heart failure, echocardiographic measures of left ventricular systolic dysfunction, dilatation and hypertrophy.

Results: Participants with gout (n=228) had two to three times higher incidence of clinical heart failure and echocardiographic measures of systolic dysfunction compared with those without. In Cox regression analyses, gout was associated with an adjusted HR of 1.74 (95% CI 1.03 to 2.93) for incident heart failure and RRs of 3.70 (95% CI 1.68 to 8.16) for abnormally low left ventricular ejection fraction and of 3.60 (95% CI 1.80 to 7.72) for global left ventricle systolic dysfunction. These risk relationships were consistently observed in all clinical subgroups. Overall, participants with gout had greater mortality than those without (adjusted HR 1.58, 95% CI 1.40 to 1.78). Mortality was elevated in subgroup of patients with gout and heart failure (adjusted HR 1.50, 95% CI 1.30 to 1.73) compared to those with heart failure but without gout.

Conclusion: Gout is associated with increased risk for clinical heart failure, subclinical measures of systolic dysfunction and mortality.

PubMed Disclaimer

Conflict of interest statement

Competing interests: EK has received honoraria, research grants, ad-board fees or consulting fees from the following entities: Ardea Biosciences, UCB, Inc., Centocor OrthoBiotech, URL Pharma, Metabolex, Takeda Pharmaceuticals and Savient Pharmaceuticals. In the past 5 years, he has held common stocks of Savient Pharmaceuticals. This manuscript does not discuss any proprietary products manufactured by these companies.

Figures

Figure 1
Figure 1
Flow diagram of participants and measurements in the present study. Data from 135 participants were not available either because the characteristics are so unique as to jeopardise de-identification process used in the Limited Access Program or they preferred the data not to be shared with non-Framingham Offspring Study Investigators.
Figure 2
Figure 2
Nelson–Aalen cumulative risk estimates for heart failure among those with and without gout (n=228 and 4761, respectively) in the Framingham Offspring Study. The number of participants at risk for heart failure in each group is provided in two rows. The number of incident cases of heart failure in each time interval is provided within parenthesis.
See this image and copyright information in PMC

References

    1. Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics–2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006;113:e85–151 - PubMed
    1. Gwadry-Sridhar FH, Flintoft V, Lee DS, et al. A systematic review and meta-analysis of studies comparing readmission rates and mortality rates in patients with heart failure. Arch Intern Med 2004;164:2315–20 - PubMed
    1. Folsom AR, Yamagishi K, Hozawa A, et al. Absolute and attributable risks of heart failure incidence in relation to optimal risk factors. Circ Heart Fail 2009;2:11–17 - PMC - PubMed
    1. Krishnan E, Pandya BJ, Chung L, et al. Hyperuricemia and the risk for subclinical coronary atherosclerosis – data from a prospective observational cohort study. Arthritis Res Ther 2011;13:R66. - PMC - PubMed
    1. Krishnan E, Baker JF, Furst DE, et al. Gout and the risk of acute myocardial infarction. Arthritis Rheum 2006;54:2688–96 - PubMed

LinkOut - more resources