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. 2017 Feb;130(2):230.e1-230.e8.
doi: 10.1016/j.amjmed.2016.09.005. Epub 2016 Oct 6.

Association Between Gout and Aortic Stenosis

Kevin Chang  1 , Chio Yokose  1 , Craig Tenner  2 , Cheongeun Oh  3 , Robert Donnino  4 , Alana Choy-Shan  5 , Virginia C Pike  1 , Binita D Shah  5 , Jeffrey D Lorin  5 , Svetlana Krasnokutsky  1 , Steven P Sedlis  5 , Michael H Pillinger  6
Affiliations

Association Between Gout and Aortic Stenosis

Kevin Chang et al. Am J Med. 2017 Feb.

Abstract

Background: An independent association between gout and coronary artery disease is well established. The relationship between gout and valvular heart disease, however, is unclear. The aim of this study was to assess the association between gout and aortic stenosis.

Methods: We performed a retrospective case-control study. Aortic stenosis cases were identified through a review of outpatient transthoracic echocardiography (TTE) reports. Age-matched controls were randomly selected from patients who had undergone TTE and did not have aortic stenosis. Charts were reviewed to identify diagnoses of gout and the earliest dates of gout and aortic stenosis diagnosis.

Results: Among 1085 patients who underwent TTE, 112 aortic stenosis cases were identified. Cases and nonaortic stenosis controls (n = 224) were similar in age and cardiovascular comorbidities. A history of gout was present in 21.4% (n = 24) of aortic stenosis subjects compared with 12.5% (n = 28) of controls (unadjusted odds ratio 1.90, 95% confidence interval 1.05-3.48, P = .038). Multivariate analysis retained significance only for gout (adjusted odds ratio 2.08, 95% confidence interval 1.00-4.32, P = .049). Among subjects with aortic stenosis and gout, gout diagnosis preceded aortic stenosis diagnosis by 5.8 ± 1.6 years. The age at onset of aortic stenosis was similar among patients with and without gout (78.7 ± 1.8 vs 75.8 ± 1.0 years old, P = .16).

Conclusions: Aortic stenosis patients had a markedly higher prevalence of precedent gout than age-matched controls. Whether gout is a marker of, or a risk factor for, the development of aortic stenosis remains uncertain. Studies investigating the potential role of gout in the pathophysiology of aortic stenosis are warranted and could have therapeutic implications.

Keywords: Aortic stenosis; Gout; Valvular heart disease.

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Conflict of interest statement

Conflict of Interest

M.H.P. and B.D.S. receive support from NYU CTSA grant 1UL1TR001445 from the National Center for the Advancement of Translational Science (NCATS), NIH. B.D.S. was supported in part by the Biomedical Laboratory Research & Development Service of the VA Office of Research and Development (I01BX007080). S.K. was supported in part by an Investigator Award from the Rheumatology Research Foundation. B.D.S. and S.K. were supported in part by a New York State Empire Clinical Research Investigator Program (ECRIP) award.

M.H.P. serves and/or has served as a consultant for AstraZeneca, Crealta/Horizon, and Sobi, and has been an investigative site for a sponsored trial by Takeda. S.K. has served as a consultant for Crealta/Horizon. B.D.S. receives research grant support from Siemens. M.H.P., B.D.S. and S.P.S. have previously received research grant support from Takeda. K.C., C.Y., C.T., A.C-S and R.D. report no disclosures.

Figures

Figure 1
Figure 1
Enrollment Diagram
Figure 2
Figure 2
Prevalence of gout history in aortic stenosis cases and non-aortic stenosis controls (24/112 vs. 28/224, 21.4% vs. 12.5%). Fisher’s exact test was used to compare groups.
See this image and copyright information in PMC

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