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

Abstract

OBJECTIVE: Gout is a sign of a disturbed metabolism and associated with atrial fibrillation (AF) and other cardio-vascular diseases. Our aim was to study associations between gout and cardiovascular co-morbidities in patients with AF. METHODS: 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 co-morbidities. 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). RESULTS: 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, socio-economic factors and comorbidities) and CHA(2)DS(2)-VASc model (adjusted for CHA(2)DS(2)-VASc, sex and age). Adding gout to full model increased Harrell's C by 1% in CHA(2)DS(2)-VASc model. CONCLUSIONS: 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 CHA(2)DS(2)-VASc without gout included.