Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Biosciences Building, Crown Street, Liverpool, L69 7BE, UK.
School of Medicine, University of Liverpool, Liverpool, UK.
Rheumatol Int. 2021 Jul;41(7):1209-1219. doi: 10.1007/s00296-021-04876-6. Epub 2021 May 13.
The aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.
本系统评价和荟萃分析的目的是描述痛风患者中心血管疾病的患病率，将这些结果与非痛风对照组进行比较，并考虑地理差异是否存在差异。通过系统检索 PubMed、Scopus 和 Web of Science，以查找报告痛风人群中心血管疾病任何疾病患病率的研究。排除了代表性抽样不足、队列在另一项研究中使用、样本量较小（<100）且痛风无法与其他风湿性疾病区分的研究，以及综述、社论和评论。在可能的情况下，使用随机效应模型进行荟萃分析。该综述纳入了 26 项研究，共纳入 949,773 例痛风患者。计算了五种心血管疾病的汇总患病率估计值：心肌梗死（2.8%；95%置信区间（CI）1.6，5.0）、心力衰竭（8.7%；95% CI 2.9，23.8）、静脉血栓栓塞症（2.1%；95% CI 1.2，3.4）、脑血管意外（4.3%；95% CI 1.8，9.7）和高血压（63.9%；95% CI 24.5，90.6）。16 项研究报告了与非痛风对照组的比较，表明痛风组在所有心血管疾病中风险增加。按国家分析结果时，未发现可识别的可靠模式。痛风患者中心血管疾病更为普遍，这应促使临床医生警惕需要评估和分层心血管风险。需要进一步研究以调查痛风、高尿酸血症与心血管风险增加之间的联系，并更全面地了解不太常见的心血管疾病的患病率。
