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. 2023 Aug 23:14:1195888.
doi: 10.3389/fendo.2023.1195888. eCollection 2023.

An elevated likelihood of stroke, ischemic heart disease, or heart failure in individuals with gout: a longitudinal follow-up study utilizing the National Health Information database in Korea

Affiliations

An elevated likelihood of stroke, ischemic heart disease, or heart failure in individuals with gout: a longitudinal follow-up study utilizing the National Health Information database in Korea

Ho Suk Kang et al. Front Endocrinol (Lausanne). .

Abstract

Objective: Accumulating evidence from other countries indicates potential associations between gout and cardiovascular diseases; however, the associations of gout with cardiovascular diseases, particularly stroke, ischemic heart disease, and heart failure, remain ambiguous in the Korean population. We hypothesized that individuals with gout are at a higher likelihood of stroke, ischemic heart disease, or heart failure. This study expands upon previous research by ensuring a comparable baseline between patient and control groups and analyzing 16 years of data derived from an extensive healthcare database.

Methods: We selected 22,480 patients with gout and 22,480 control individuals from the Korean National Health Insurance Service-Health Screening Cohort database (2002-2019), and matched them at a 1:1 ratio according to sex, age, income, and residence. A Cox proportional hazard model with weighted overlap was employed to examine the relationship between gout and the risk of stroke, ischemic heart disease, or heart failure after adjustment for several covariates.

Results: The incidences of stroke, ischemic heart disease, or heart failure in participants with gout were slightly higher than those in controls (stroke: 9.84 vs. 8.41 per 1000 person-years; ischemic heart disease: 9.77 vs. 7.15 per 1000 person-years; heart failure: 2.47 vs. 1.46 per 1000 person-years). After adjustment, the gout group had an 11% (95% confidence interval [CI] = 1.04-1.19), 28% (95% CI = 1.19-1.37), or 64% (95% CI = 1.41-1.91) higher likelihood of experiencing stroke, ischemic heart disease, or heart failure, respectively, than the control group.

Conclusion: The present findings suggest that individuals with gout in the Korean population, particularly those aged ≥ 60 years, were more likely to have stroke, ischemic heart disease, or heart failure.

Keywords: cardiovascular diseases; gout; heart failure; ischemic heart disease; longitudinal follow-up study; nationwide health insurance research database; stroke.

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Conflict of interest statement

Author HC was employed by the company M.D. Analytics. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow of participant selection. Of the total 514,866 participants, 22,480 individuals with gout were paired with age, sex, financial status, and residential area-matched 22,480 controls. ICD-10, International classification of disease-10; CCI, Charlson comorbidity index; SBP, Systolic blood pressure; DBP, Diastolic blood pressure.
Figure 2
Figure 2
Kaplan-Meier probability of the incidence of stroke (A), ischemic heart disease (B), and heart failure (C) in gout and the control populations within 16 years of the index date.
Figure 3
Figure 3
Forest plots for hazard ratios (95% confidence intervals [CI]) for the probability of stroke (A), ischemic heart disease (B), and heart failure (C) based on age and sex.

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