Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK.
Rheumatology (Oxford). 2013 Dec;52(12):2251-9. doi: 10.1093/rheumatology/ket293. Epub 2013 Sep 17.
Some studies suggest that gout is a risk factor for cardiovascular disease. There is more evidence about the association between gout and acute myocardial infarction (MI) than about gout and stroke, and only limited information about risks by age group and sex. We aimed to study MI and stroke following gout, including types of stroke, by age group and comparing men and women.
We analysed an all-England national linked dataset of hospital admissions and death records from 1999 to 2011, and a similar dataset in the Oxford Record Linkage Study spanning 1963-98. The occurrence of MI and stroke was estimated in cohorts of patients admitted to hospital with gout, compared with MI and stroke in control cohorts, and the comparisons were expressed as rate ratios (RRs).
The risk of MI and stroke was elevated, and similar, in both datasets. In the all-England dataset, which included 202 033 hospital patients with gout, the RR for MI following gout was 1.82 (95% CI 1.78, 1.85), for all stroke 1.71 (1.68, 1.75), ischaemic stroke 1.68 (1.64, 1.73), haemorrhagic stroke 1.69 (1.61, 1.77) and stroke of unspecified type 2.00 (1.95, 2.06). Associations were stronger in younger than older age groups, and in the younger were stronger in women than men.
Gout was associated with increased risk of stroke as well as MI. These findings should be considered by clinicians and may have implications for preventive management of circulatory disease risks in people with gout.
一些研究表明痛风是心血管疾病的一个风险因素。相较于痛风与中风的关系，人们对痛风与急性心肌梗死（MI）之间的关联有更多的证据，而关于年龄组和性别相关风险的信息则非常有限。我们旨在研究痛风后 MI 和中风的发病情况，包括中风类型、按年龄组和性别进行比较。
我们分析了 1999 年至 2011 年全英格兰国家住院和死亡记录的一个关联数据集，以及牛津记录链接研究（1963-98 年）中的一个类似数据集。通过与对照组相比，估计了因痛风住院的患者队列中 MI 和中风的发病情况，并以发病率比（RR）表示比较结果。
在两个数据集均观察到 MI 和中风的风险升高，且相似。在包括 202033 名痛风住院患者的全英格兰数据集，痛风后 MI 的 RR 为 1.82（95%CI 1.78,1.85），所有中风为 1.71（1.68,1.75），缺血性中风为 1.68（1.64,1.73），出血性中风为 1.69（1.61,1.77），未明确类型的中风为 2.00（1.95,2.06）。在年龄较小的年龄组中，关联更强，在年龄较小的患者中，女性的关联强于男性。
痛风与中风和 MI 的风险增加相关。这些发现应引起临床医生的注意，并可能对痛风患者循环系统疾病风险的预防性管理产生影响。
