Article

Hyperuricaemia, the biochemical precursor to gout, has been shown to
be an independent risk factor for mortality from cardiovascular disease (CVD),
although studies examining the clinical phenomenon of gout and risk of CVD
mortality report conflicting results. This study aimed to produce a pooled
estimate of risk of mortality from cardiovascular disease in patients with gout.
DESIGN: Systematic review and meta-analysis. METHODS: Electronic bibliographic
databases were searched from inception to November 2012, with results reviewed by
two independent reviewers. Studies were included if they reported data on CVD
mortality in adults with gout who were free of CVD at time of entry into the
study. Pooled hazard ratios (HRs) for this association were calculated both
unadjusted and adjusted for traditional vascular risk factors. RESULTS: Six
papers, including 223,448 patients, were eligible for inclusion (all (CVD)
mortality n = 4, coronary heart disease (CHD) mortality n = 3, and myocardial
infarction mortality n = 3). Gout was associated with an excess risk of CVD
mortality (unadjusted HR 1.51 (95% confidence interval, CI, 1.17-1.84)) and CHD
mortality (unadjusted HR 1.59, 95% CI 1.25-1.94)). After adjusting for
traditional vascular risk factors, the pooled HR for both CVD mortality (HR 1.29,
95% CI 1.14-1.44) and CHD mortality (HR 1.42, 95% CI 1.22-1.63) remained
statistically significant, but none of the studies reported a significant
association with myocardial infarction. CONCLUSIONS:
Gout increases the risk of
mortality from CVD and CHD, but not myocardial infarction, independently of
vascular risk factors.
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Langue : ANGLAIS