Gout and risk for subsequent coronary heart disease - The Meharry-Hopkins study
Gout and risk for subsequent coronary heart disease - The Meharry-Hopkins study
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DOI：
10.1001/archinte.157.13.1436
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发表时间：
1997-07-14
影响因子：
--
通讯作者：
Hochberg, MC
中科院分区：
文献类型：
--
作者：
Gelber, AC;Klag, MJ;Hochberg, MC
背景：痛风患者是临床上常见的疾病。以前的研究表明，高尿酸血症和痛风是美国男性最常见的死亡原因-冠心病(CHD)的危险因素。方法：前瞻性地收集了两项针对前医科学生的纵向队列研究的数据-Meharry队列研究中的371名黑人男性和Johns Hopkins前体研究中的1181名白人男性。痛风和冠心病的发展是由医生自我报告确定的，并通过已发表的标准进行验证。用COX比例风险分析评估痛风相关的冠心病风险。结果：在中位随访的30年中，Meharry组有38例痛风病例和43例CHD事件，而Hopkins组有68例痛风病例和138例CHD事件。在Meharry男性或Hopkins男性中，既往痛风与CI-ID事件风险增加(相对风险=1.20；95%可信区间，0.37-3.92)无关(相对风险=0.66；95%可信区间)。0.24-1.79)。经已知的冠心病危险因素调整后的多变量分析不会改变这些发现。结论：在黑人和白人男性医生中，这些结果并不表明男性在冠心病的一级预防中有针对性地识别痛风。
Background: Patients with gout are encountered frequently in clinical practice. Previous studies have suggested that hyperuricemia and gout ma) represent risk factors for coronary heart disease (CHD), the most common cause of death in American men.Methods: Prospectively collected data from 2 longitudinal cohort studies of former medical students-371 black men in the Meharry Cohort Study and 1181 white men in the Johns Hopkins Precursors Study-were analyzed. The development of gout and of CHD was determined by physician self-report, and validated by using published criteria. The risk for CHD associated with gout was evaluated using Cox proportional hazards analysis. Results: During a median follow-up of 30 years, there were 38 gout cases and 43 CHD events among the Meharry men, and 68 gout cases and 138 CHD events among the Hopkins men. Prior gout was not associated with an increased risk for incident CI-ID (relative risk=1.20; 95% confidence interval, 0.37-3.92) among the Meharry men or among the Hopkins men (relative risk=0.66; 95% confidence interval. 0.24-1.79). Multivariate analysis adjusted for known CHD risk factors did not alter these findings. Conclusion: These results, in black and white male physicians, do not suggest a role in men for targeting gout identification in the primary prevention of CHD.