The risk of myocardial infarction and heart failure in patients with gouty arthritis: A systematic review and meta‐analysis

OBJECTIVE: By performing a meta-analysis of published cohort studies, this review aims to evaluate the association between gouty arthritis (GA) and the risk of myocardial infarction (MI) and heart failure (HF), hence providing evidence for clinical management. METHODS: Five electronic databases were searched from inception to July 28, 2022. Relative risk (RR) and 95% confidence intervals (CI) were calculated by random-effect model or fixed-effect model to evaluate the association between GA and the risk of MI and HF, respectively. RESULTS: Eleven articles containing 13 studies were finally selected for meta-analysis which covered 408 443 GA patients and 10 402 777 non-GA patients. The results showed that GA was associated with the risk of MI and HF (MI: RR = 1.75, 95% CI: 1.45-2.11; HF: RR = 2.00, 95% CI: 1.91-2.10). And subgroup analysis showed that female GA patients had a higher risk of MI and HF than male GA patients. Further, younger GA patients had a higher risk of MI than older patients (≤44 years: RR = 2.82, 95% CI: 1.38-5.79; 45-69: RR = 1.85, 95% CI: 1.22-2.82; ≥70: RR = 1.52, 95% CI: 1.22-1.88). GA patients were mainly associated with the occurrence of non-fatal MI (fatal MI: RR = 1.37, 95% CI: 0.76-2.48; non-fatal MI: RR = 1.75, 95% CI: 1.45-2.11). CONCLUSIONS: GA is correlated with the risk of MI and HF. Both male and female GA patients have an increased risk of MI and HF. Meanwhile, female GA patients or younger GA patients have a higher risk of MI and HF.