Ten-year cardiovascular risk changes and major adverse events in gout patients

Objective The long-term interaction between cardiovascular (CV) risk profiles and gout may influence the risk of cardiovascular events. However, the impact of gout and long-term changes in CV risk profile on CV events is unclear. Methods This was a nationwide cohort study based on the Korean National Health Insurance claims database and the National Health Screening Program. Patients aged 20–90 years newly diagnosed with gout after January 2012 and age- and sex-matched controls without gout were included. After adjusting for CV risk profiles measured 10 years before gout diagnosis and their long-term changes, the relative risks of incident CV events (myocardial infarction, cerebral infarction and cerebral haemorrhage) and all-cause death in the gout patients were assessed. Results In total, 113 853 patients with gout and 1 138 530 matched controls were studied. Multivariable analysis showed that gout was associated with increased risks for myocardial infarction (hazard ratio [HR]: 1.39, P < 0.001), cerebral infarction (HR: 1.36, P < 0.001), cerebral haemorrhage (HR: 1.50, P < 0.001), and all-cause death (HR: 1.07, P = 0.004). In addition, significant interactions were observed for myocardial infarction (Grade 1 aggravation over 10 years of diastolic blood pressure [DBP], P = 0.042), cerebral infarction (Grade 2 aggravation over 10 years of DBP, P = 0.037) and cerebral haemorrhage (Grade 2 aggravation over 10 years of total cholesterol, P = 0.057). Conclusions Gout patients had a high risk of incident CV events even after adjusting for CV risk profiles and their long-term changes. These long-term changes additively increase the risk of CV events in gout patients.