Sedighi Jamschid, Luedde Mark, Gaensbacher-Kunzendorf Julia, Sossalla Samuel, Kostev Karel
Medical Clinic I, Cardiology and Angiology, Justus-Liebig-University, Klinikstraße 33, 35392, Giessen, Germany.
Department of Cardiology, Angiology and Intensive Care Medicine, University Medical Center of Schleswig Holstein, Campus Kiel, Kiel, Germany.
Clin Res Cardiol. 2024 Sep 10. doi: 10.1007/s00392-024-02537-9.
Both the risk of developing heart disease and the course of the disease are determined in particular by comorbidities. In this context, gout has recently been identified as an important factor in influencing the development of cardiovascular events such as heart failure or coronary artery disease.
This retrospective cohort study compared the incidence of angina pectoris (AP) (ICD-10: I20), myocardial infarction (MI) (ICD-10: I21, I22), chronic coronary heart disease (CHD) (ICD-10: I25), atrial fibrillation (AF), and heart failure (HF) as a function of gout in Germany in a large collective of 66,000 gout patients in comparison to 66,000 individuals without gout between using propensity score matching (1:1) from January 2005 to December 2020.
Within 10 years after the index date, AP was diagnosed in 5.2% of gout and 2.9% of non-gout patients (p < 0.001), MI in 3.1% of gout and 2.2% of non-gout patients (p < 0.001), CHD in 16.5% of gout and 11.8% of non-gout patients, AF in 12.6% of gout and 8.4% of non-gout patients (p < 0.001), and HF in 14.7% of gout and 8.5% of non-gout patients (p < 0.001). For all diagnoses except CHD, the association was stronger in male than in female patients.
The relationship shown between gout and cardiovascular disease indicates that gout could be one of a series of inflammatory conditions that increase the risk of cardiac disease. The association we have shown between gout and all major cardiac diseases suggests that there is a risk modifier, the treatment of which could help prevent these diseases. Further research is needed to determine whether treating gout can effectively reduce this risk.
患心脏病的风险和疾病进程尤其由合并症决定。在此背景下，痛风最近被确定为影响心血管事件（如心力衰竭或冠状动脉疾病）发生发展的一个重要因素。
这项回顾性队列研究比较了德国66000名痛风患者与66000名无痛风个体中，心绞痛（AP）（国际疾病分类第十版：I20）、心肌梗死（MI）（国际疾病分类第十版：I21、I22）、慢性冠状动脉疾病（CHD）（国际疾病分类第十版：I25）、心房颤动（AF）和心力衰竭（HF）的发病率，研究采用倾向得分匹配法（1:1），时间跨度为2005年1月至2020年12月。
在索引日期后的10年内，痛风患者中5.2%被诊断为AP，非痛风患者中为2.9%（p<0.001）；痛风患者中3.1%被诊断为MI，非痛风患者中为2.2%（p<0.001）；痛风患者中16.5%患有CHD，非痛风患者中为11.8%；痛风患者中12.6%患有AF，非痛风患者中为8.4%（p<0.001）；痛风患者中14.7%患有HF，非痛风患者中为8.5%（p<0.001）。除CHD外，所有诊断的关联在男性患者中比在女性患者中更强。
痛风与心血管疾病之间的关系表明，痛风可能是增加心脏病风险的一系列炎症性疾病之一。我们所显示的痛风与所有主要心脏病之间的关联表明存在一种风险调节因素，对其进行治疗可能有助于预防这些疾病。需要进一步研究以确定治疗痛风是否能有效降低这种风险。
