Department of Pharmacy, University of Virginia Health, Charlottesville, Virginia, USA.
Department of Medicine-Cardiovascular Medicine, University of Virginia Health, Charlottesville, Virginia, USA.
Clin Cardiol. 2022 Jul;45(7):733-741. doi: 10.1002/clc.23830. Epub 2022 Apr 28.
Gout is a common comorbidity in heart failure (HF) patients and is frequently associated with acute exacerbations during treatment for decompensated HF. Although colchicine is often used to manage acute gout in HF patients, its impact on clinical outcomes when used during acute decompensated HF is unknown.
This was a single center, retrospective study of hospitalized patients treated for an acute HF exacerbation with and without acute gout flare between March 2011 and December 2020. We assessed clinical outcomes in patients treated with colchicine for a gout flare compared to those who did not experience a gout flare or receive colchicine. The primary outcome was in-hospital all-cause mortality.
Among 1047 patient encounters for acute HF during the study period, there were 237 encounters (22.7%) where the patient also received colchicine for acute gout during admission. In-hospital all-cause mortality was significantly reduced in the colchicine group compared with the control group (2.1% vs. 6.5%, p = .009). The colchicine group had increased length of stay (9.93 vs. 7.96 days, p < .001) but no significant difference in 30-day readmissions (21.5% vs. 19.5%, p = .495). In a Cox proportional hazards model adjusted for age, inpatient colchicine use was associated with improved survival to discharge (hazards ratio [HR] 0.163, 95% confidence interval [CI] 0.051-0.525, p = .002) and a reduced rate of in-hospital CV mortality (HR 0.184, 95% CI 0.044-0.770, p = .021).
Among patients with a HF exacerbation, treatment with colchicine for a gout flare was associated with significantly lower in-hospital mortality compared with those not treated for acute gout.
痛风是心力衰竭（HF）患者常见的合并症，并且在治疗失代偿性 HF 时经常与急性加重有关。尽管秋水仙碱常用于治疗 HF 患者的急性痛风，但在急性失代偿性 HF 期间使用时对临床结局的影响尚不清楚。
这是一项单中心、回顾性研究，纳入 2011 年 3 月至 2020 年 12 月期间因急性 HF 加重住院且伴有或不伴有急性痛风发作的患者。我们评估了接受秋水仙碱治疗痛风发作的患者与未经历痛风发作或未接受秋水仙碱治疗的患者的临床结局。主要结局是住院期间全因死亡率。
在研究期间，因急性 HF 住院的 1047 例患者中，有 237 例（22.7%）患者在住院期间还因急性痛风接受了秋水仙碱治疗。与对照组相比，秋水仙碱组的院内全因死亡率显著降低（2.1% vs. 6.5%，p=0.009）。秋水仙碱组的住院时间延长（9.93 天 vs. 7.96 天，p<0.001），但 30 天再入院率无显著差异（21.5% vs. 19.5%，p=0.495）。在调整年龄的 Cox 比例风险模型中，住院期间使用秋水仙碱与改善出院时的生存相关（风险比 [HR] 0.163，95%置信区间 [CI] 0.051-0.525，p=0.002），并降低住院期间心血管死亡率（HR 0.184，95% CI 0.044-0.770，p=0.021）。
在 HF 加重的患者中，秋水仙碱治疗痛风发作与院内死亡率显著降低相关，与未接受急性痛风治疗的患者相比。
