The Association Between Gout and Cardiovascular Disease in Patients with Atrial Fibrillation

Abstract

Gout is a sign of a disturbed metabolism and associated with atrial fibrillation (AF) and other cardiovascular diseases. Our aim was to study associations between gout and cardiovascular comorbidities in patients with AF. The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF visiting 75 primary care centers in Sweden 2001–2007. Logistic regression was used to calculate odds ratios with 95% confidence intervals (CIs) for the associations between prevalent gout and cardiovascular comorbidities. In subsamples, we studied incident congestive heart failure (CHF) and ischemic stroke (IS), excluding patients with earlier registered specific diagnosis, using Cox regression (to estimate hazard ratios (HR) with 95% CIs). Gout was significantly and positively associated with CHF, obesity and diabetes among men and women, and among men also with hypertension and coronary heart disease. Prevalent gout was negatively associated with incident IS (HR and 95% CI: 0.64, 0.49–0.82; 0.50, 0.39–0.64) in both full model (adjusted for sex, age, socioeconomic factors, and comorbidities) and CHA2DS2-VASc model (adjusted for CHA2DS2-VASc, sex, and age). Adding gout to full model increased Harrell’s C by 1% in CHA2DS2-VASc model. In this clinical setting, we found gout to be associated with most cardiometabolic diseases except cerebrovascular diseases, and with decreased risk of IS, with gout adding significantly to the predictive value compared to CHA2DS2-VASc without gout included.