Hyperuricemia and gout linked to acute MI risk

A recent large prospective study confirms hyperuricemia and gouty arthritis as independent risk factors for acute myocardial infarction.Dr Eswar Krishnan (University of Pittsburgh) and colleagues note that the few studies examining the association between gout and acute MI had inconclusive findings. Therefore, to investigate further the authors followed 12,866 men identified at high risk of coronary events based on their smoking status, hyperlipidemia, and hypertension.Hyperuricemia was defined as a serum uric acid concentration of 7.0 mg/dL or higher, and the diagnosis of gout included joint pain, swelling, and heat lasting for up to two weeks, followed by complete remission of symptoms.The 12,866 men (mean age 46 years old) were followed-up for approximately 6.5 years. At enrolment the prevalence of gout and hyperuricemia was 8.7% and 41.5%, with the baseline serum uric acid concentration higher in those with gout than those without (8.0 versus 6.7 mg/dL, p Gout was not associated with cholesterol levels, aspirin use, family history of acute MI, and cumulative incidence of diabetes.Over the study period 1,108 subjects had an acute MI [118 in the group with gout (10.5%) and 990 events in the group without gout (8.43%)].After controlling for demographics, lifestyle, as well as use of aspirin, diuretic, alcohol, and other potential confounders the risk of acute MI incidence was greater in those with hyperuricemia (p The authors highlight that whilst the absolute magnitude of the risk associated with gout was not high, "the odds ratio associated with gout was the third largest among categorical variables, after smoking and family history of acute MI."The authors conclude, "The independent risk relationship between hyperuricemia and acute MI is confirmed".Reference...