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Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality

Rheumatic & musculoskeletal diseases open, 2019-10, Vol.5 (2), p.e001015-e001015 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ;2019 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2019 ;ISSN: 2056-5933 ;EISSN: 2056-5933 ;DOI: 10.1136/rmdopen-2019-001015 ;PMID: 31673414

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Title:
Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality
Author: Pérez Ruiz, Fernando ; Richette, Pascal ; Stack, Austin G ; Karra Gurunath, Ravichandra ; García de Yébenes, Ma Jesus ; Carmona, Loreto
Subjects: Aged ; Arthritis ; Atherosclerosis ; Biomarkers ; Blood pressure ; Cardiovascular disease ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Comorbidity ; Crystal Arthropathies ; Data collection ; Drug dosages ; Female ; Follow-Up Studies ; Gout - blood ; Gout - complications ; Gout - diagnosis ; Humans ; Hypertension ; Hyperuricemia - blood ; Hyperuricemia - complications ; Hyperuricemia - diagnosis ; Male ; Middle Aged ; Mortality ; Patients ; Prognosis ; Rheumatism ; Rheumatology ; Survival Analysis ; Ultrasonic imaging ; Uric acid ; Uric Acid - blood
Is Part Of: Rheumatic & musculoskeletal diseases open, 2019-10, Vol.5 (2), p.e001015-e001015
Description: ObjectiveTo determine the impact of achieving serum uric acid (sUA) of <0.36 mmol/L on overall and cardiovascular (CV) mortality in patients with gout.MethodsProspective cohort of patients with gout recruited from 1992 to 2017. Exposure was defined as the average sUA recorded during the first year of follow-up, dichotomised as ≤ or >0.36 mmol/L. Bivariate and multivariate Cox proportional hazards models were used to determine mortality risks, expressed HRs and 95% CIs.ResultsOf 1193 patients, 92% were men with a mean age of 60 years, 6.8 years’ disease duration, an average of three to four flares in the previous year, a mean sUA of 9.1 mg/dL at baseline and a mean follow-up 48 months; and 158 died. Crude mortality rates were significantly higher for an sUA of ≥0.36 mmol/L, 80.9 per 1000 patient-years (95% CI 59.4 to 110.3), than for an sUA of <0.36 mmol/L, 25.7 per 1000 patient-years (95% CI 21.3 to 30.9). After adjustment for age, sex, CV risk factors, previous CV events, observation period and baseline sUA concentration, an sUA of ≥0.36 mmol/L was associated with elevated overall mortality (HR=2.33, 95% CI 1.60 to 3.41) and CV mortality (HR=2.05, 95% CI 1.21 to 3.45).ConclusionsFailure to reach a target sUA level of 0.36 mmol/L in patients with hyperuricaemia of gout is an independent predictor of overall and CV-related mortality. Targeting sUA levels of <0.36 mmol/L should be a principal goal in these high-risk patients in order to reduce CV events and to extend patient survival.
Publisher: England: BMJ Publishing Group LTD
Language: English
Identifier: ISSN: 2056-5933
EISSN: 2056-5933
DOI: 10.1136/rmdopen-2019-001015
PMID: 31673414
Source: BMJ Open Access Journals
MEDLINE
PubMed Central
ROAD: Directory of Open Access Scholarly Resources
ProQuest Central
DOAJ Directory of Open Access Journals

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Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality

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