Cipolletta Edoardo, Nakafero Georgina, Richette Pascal, Avery Anthony J, Mamas Mamas A, Tata Laila J, Abhishek Abhishek
University of Nottingham, Nottingham, United Kingdom, and Polytechnic University of Marche, Ancona, Italy.
University of Nottingham, Nottingham, United Kingdom.
Arthritis Rheumatol. 2025 Feb;77(2):202-211. doi: 10.1002/art.42986. Epub 2024 Oct 17.
To investigate the temporal association between the first diagnosis of gout and cardiovascular events in the short term.
We performed a self-controlled case series analysis and a cohort study using data from linked primary care, hospitalization, and mortality records from the United Kingdom's Clinical Practice Research Database-GOLD. We included individuals with a new diagnosis of gout either in the primary care or secondary care between January 1, 1997 and December 31, 2020. The first consultation at which gout was diagnosed was the exposure of interest. The main outcome consisted of cardiovascular events (ie, a composite of fatal and nonfatal myocardial infarction, ischemic or hemorrhagic stroke, and transient ischemic attack).
The 4,398 patients (66.9% male, mean age 74.6 years) had a cardiovascular event within at least two years of their first recorded diagnosis of gout. The incidence of cardiovascular events was significantly higher in the 30 days after the first diagnosis of gout compared to baseline (adjusted incidence rate ratio 1.55, 95% confidence interval [CI] 1.33-1.83). Among 76,440 patients (72.9% male, mean age 63.2 years) included in the cohort study, the incidence of cardiovascular events in the 30 days after the first gout diagnosis (31.2 events per 1,000 person-years, 95% CI 27.1-35.9) was significantly higher than in days 31 to 730 after gout diagnosis (21.6 events per 1,000 person-years, 95% CI 20.8-22.4) with a rate difference of -9.6 events per 1,000 person-years (95% CI -14.0 to -5.1).
Individuals had a short-term increased risk of cardiovascular events in the 30 days following the first consultation at which gout was diagnosed.
调查痛风首次诊断与短期内心血管事件之间的时间关联。
我们使用来自英国临床实践研究数据库-GOLD的关联初级保健、住院和死亡记录数据进行了一项自我对照病例系列分析和一项队列研究。我们纳入了1997年1月1日至2020年12月31日期间在初级保健或二级保健中首次诊断为痛风的个体。诊断痛风的首次会诊是感兴趣的暴露因素。主要结局包括心血管事件（即致命和非致命心肌梗死、缺血性或出血性中风以及短暂性脑缺血发作的综合）。
4398例患者（66.9%为男性，平均年龄74.6岁）在首次记录诊断痛风后的至少两年内发生了心血管事件。与基线相比，痛风首次诊断后30天内心血管事件的发生率显著更高（调整后的发病率比为1.55，95%置信区间[CI]为1.33-1.83）。在队列研究纳入的76440例患者（72.9%为男性，平均年龄63.2岁）中，痛风首次诊断后30天内心血管事件的发生率（每1000人年31.2例事件，95%CI为27.1-35.9）显著高于痛风诊断后31至730天（每1000人年21.6例事件，95%CI为20.8-22.4），率差为每1000人年-9.6例事件（95%CI为-14.0至-5.1）。
在诊断痛风的首次会诊后的30天内，个体发生心血管事件的短期风险增加。
