痛风患者的中风风险：台湾一项全国性回顾性队列研究

Stroke Risk in Patients with Gout: A Nationwide Retrospective Cohort Study in Taiwan.

作者信息

Tsai Ping-Han, Kuo Chang-Fu, See Lai-Chu, Li Pei-Ru, Chen Jung-Sheng, Tseng Wen-Yi

机构信息

Division of Rheumatology, Allergy and Immunology, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 236, Taiwan.

Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan City 333, Taiwan.

出版信息

J Clin Med. 2022 Jun 29;11(13):3779. doi: 10.3390/jcm11133779.

DOI:10.3390/jcm11133779

PMID:35807064

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9267343/

Abstract

OBJECTIVES

To estimate stroke risk in Taiwanese patients with gout.

METHODS

We enrolled patients from the Taiwan National Health Insurance Database, with gout diagnosed from 2000 to 2008, and followed them up until December 2018. This cohort was propensity score-matched according to birth year, sex, the date of diagnosis of gout, comorbidities, and co-medications with individuals without gout (controls) ( = 310,820 in each group). Stroke was defined as the primary diagnosis at discharge after the index date. To evaluate ischemic and hemorrhagic stroke risks, we calculated their incidence, hazard ratio (HR), and two-year moving average incidence rate.

RESULTS

The incidence (95% CI) and HR of ischemic stroke were lower in the gout group than in the control group in the first 3 years (incidence: 4.74 [4.60-4.88] vs. 5.17 [5.03-5.32] per 1000 person-years; HR: 0.92 [0.88-0.96]), then became significantly higher than in the control group after 3 years (incidence: 4.10 [4.04-4.16] vs. 3.81 [3.75-3.87] per 1000 person-years; HR: 1.08 [1.05-1.10]). Similarly, the incidence (95% CI) and HR of hemorrhagic stroke was lower in the gout group than in the control group in the first 3 years (incidence: 1.51 [1.43-1.59] vs. 1.70 [1.62-1.79] per 1000 person-years; HR: 0.88 [0.82-0.92]), then became significantly higher than in controls after 3 years (incidence: 1.43 [1.39-1.46] vs. 1.26 [1.22-1.29] per 1000 person-years; HR: 1.14 [1.10-1.18]).

CONCLUSIONS

In Taiwan, patients with gout had higher risks of ischemic and hemorrhagic stroke after 3 years.

摘要

目的

评估台湾痛风患者的中风风险。

方法

我们从台湾国民健康保险数据库中纳入了2000年至2008年被诊断为痛风的患者，并对他们进行随访直至2018年12月。该队列根据出生年份、性别、痛风诊断日期、合并症以及联合用药情况，与无痛风的个体（对照组）进行倾向评分匹配（每组n = 310,820）。中风定义为索引日期后出院时的主要诊断。为评估缺血性和出血性中风风险，我们计算了它们的发病率、风险比（HR）以及两年移动平均发病率。

结果

痛风组缺血性中风的发病率（95%CI）和HR在最初3年低于对照组（发病率：每1000人年4.74 [4.60 - 4.88] 对比5.17 [5.03 - 5.32]；HR：0.92 [0.88 - 0.96]），但在3年后显著高于对照组（发病率：每1000人年4.10 [4.04 - 4.16] 对比3.81 [3.75 - 3.87]；HR：1.08 [1.05 - 1.10]）。同样，痛风组出血性中风的发病率（95%CI）和HR在最初3年低于对照组（发病率：每1000人年1.51 [1.43 - 1.59] 对比1.70 [1.62 - 1.79]；HR：0.88 [0.82 - 0.92]），但在3年后显著高于对照组（发病率：每1000人年1.43 [1.39 - 1.46] 对比1.26 [1.22 - 1.29]；HR：1.14 [1.10 - 1.18]）。