Independent impact of gout on mortality and risk for coronary heart disease
Independent impact of gout on mortality and risk for coronary heart disease
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DOI：
10.1161/circulationaha.107.703389
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发表时间：
2007-08-21
期刊：
影响因子：
37.8
通讯作者：
Curhan, Gary
中科院分区：
文献类型：
--
作者：
Choi, Hyon K.;Curhan, Gary
背景-尽管痛风和高尿酸血症与几种与生存率降低相关的疾病有关，但没有关于痛风对死亡率独立影响的前瞻性数据。此外，尽管许多研究表明高尿酸血症与心血管疾病（CVD）有关，但痛风对CVD的影响数据有限。方法和结果：在12年的时间里，我们前瞻性地研究了5297名健康专业人员随访研究的男性参与者的痛风病史与死亡和心肌梗死风险之间的关系。在12年的随访中，我们记录了5825例各种原因的死亡，其中2132例死于心血管疾病，1576例死于冠心病。与基线时无痛风和冠心病病史的男性相比，有痛风病史的男性总死亡率的多因素相对危险度为1.28(95%可信区间[CI]， 1.15至1.41)，心血管疾病死亡的多因素相对危险度为1.38 (95% CI， 1.15至1.66)，致死性冠心病的多因素相对危险度为1.55 （95% CI， 1.24至1.93）。先前存在冠心病的男性相应的相对危险度分别为1.25 （95% CI, 1.09 - 1.45）、1.26 （95% CI, 1.07 - 1.50）和1.24 （95% CI, 1.04 - 1.49）。此外，痛风患者发生非致死性心肌梗死的风险高于无痛风患者（多变量相对危险度，1.59;95% CI, 1.04 - 2.41）。结论：这些前瞻性数据表明，男性痛风患者死于各种原因的风险更高。在先前没有冠心病的男性中，死亡风险的增加主要是由于心血管疾病死亡风险的增加，特别是冠心病。
Background - Although gout and hyperuricemia are related to several conditions that are associated with reduced survival, no prospective data are available on the independent impact of gout on mortality. Furthermore, although many studies have suggested that hyperuricemia is associated with cardiovascular disease ( CVD), limited data are available on the impact of gout on CVD.Methods and Results - Over a 12-year period, we prospectively examined the relation between a history of gout and the risk of death and myocardial infarction in 51 297 male participants of the Health Professionals Follow-Up Study. During the 12 years of follow-up, we documented 5825 deaths from all causes, which included 2132 deaths from CVD and 1576 deaths from coronary heart disease (CHD). Compared with men without history of gout and CHD at baseline, the multivariate relative risks among men with history of gout were 1.28 (95% confidence interval [CI], 1.15 to 1.41) for total mortality, 1.38 (95% CI, 1.15 to 1.66) for CVD deaths, and 1.55 (95% CI, 1.24 to 1.93) for fatal CHD. The corresponding relative risks among men with preexisting CHD were 1.25 (95% CI, 1.09 to 1.45), 1.26 (95% CI, 1.07 to 1.50), and 1.24 (95% CI, 1.04 to 1.49), respectively. In addition, men with gout had a higher risk of nonfatal myocardial infarction than men without gout (multivariate relative risk, 1.59; 95% CI, 1.04 to 2.41).Conclusions - These prospective data indicate that men with gout have a higher risk of death from all causes. Among men without preexisting CHD, the increased mortality risk is primarily a result of an elevated risk of CVD death, particularly from CHD.