Yasuhiko Kubota1, Mara McAdams-DeMarco2, Aaron R Folsom3. 1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: kubot007@umn.edu. 2. Departments of Epidemiology and Surgery, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States. 3. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
Abstract
INTRODUCTION: Inflammatory diseases increase risk of venous thromboembolism (VTE). Whether gout, the most common rheumatologic inflammatory arthritis, or its cause, elevated serum uric acid (SUA), is associated with VTE incidence is unknown. MATERIALS AND METHODS: The Atherosclerosis Risk in Communities Study measured SUA in 14126 participants aged 45-64, without a history of VTE or gout and not using anticoagulants/gout medications, and obtained information on incident gout between 1987 and 1998 from 10247. We followed them for VTE occurrence from 1987 to 2011. Hazard ratios (HRs) of VTE were estimated using Cox proportional hazards models. RESULTS: We documented 632 incident cases of VTE (236 unprovoked and 396 provoked). Age, sex, and race-adjusted HRs for total VTE were 1, 1.40, 1.43, 1.91, 1.71, and 3.25 (P for trend<0.001) across levels of SUA (range mg/dL: ≤4.9, 5.0-5.9, 6.0-6.9, 7.0-7.5, 7.6-8.7, and ≥8.8). After adjustment for other VTE risk factors, those in the highest level of SUA had HRs [95% confidence interval] of 2.13 (1.47-3.07) for total VTE, 2.07 (1.17-3.67) for unprovoked VTE and 2.16 (1.33-3.50) for provoked VTE. Those with incident gout had a nonsignificantly increased risk of total VTE [HR (95% CI): 1.33 (0.95-1.86)]. CONCLUSIONS: Elevated SUA was associated with an increased risk of VTE, suggesting that SUA might be a novel risk factor or marker for VTE. Further studies are needed to assess the association between gout and VTE.
INTRODUCTION: Inflammatory diseases increase risk of venous thromboembolism (VTE). Whether gout, the most common rheumatologic inflammatory arthritis, or its cause, elevated serum uric acid (SUA), is associated with VTE incidence is unknown. MATERIALS AND METHODS: The Atherosclerosis Risk in Communities Study measured SUA in 14126 participants aged 45-64, without a history of VTE or gout and not using anticoagulants/gout medications, and obtained information on incident gout between 1987 and 1998 from 10247. We followed them for VTE occurrence from 1987 to 2011. Hazard ratios (HRs) of VTE were estimated using Cox proportional hazards models. RESULTS: We documented 632 incident cases of VTE (236 unprovoked and 396 provoked). Age, sex, and race-adjusted HRs for total VTE were 1, 1.40, 1.43, 1.91, 1.71, and 3.25 (P for trend<0.001) across levels of SUA (range mg/dL: ≤4.9, 5.0-5.9, 6.0-6.9, 7.0-7.5, 7.6-8.7, and ≥8.8). After adjustment for other VTE risk factors, those in the highest level of SUA had HRs [95% confidence interval] of 2.13 (1.47-3.07) for total VTE, 2.07 (1.17-3.67) for unprovoked VTE and 2.16 (1.33-3.50) for provoked VTE. Those with incident gout had a nonsignificantly increased risk of total VTE [HR (95% CI): 1.33 (0.95-1.86)]. CONCLUSIONS: Elevated SUA was associated with an increased risk of VTE, suggesting that SUA might be a novel risk factor or marker for VTE. Further studies are needed to assess the association between gout and VTE.
Authors: Hussain R Yusuf; W Craig Hooper; Scott D Grosse; Christopher S Parker; Sheree L Boulet; Thomas L Ortel Journal: Thromb Res Date: 2014-10-22 Impact factor: 3.944
Authors: Nicola Dalbeth; Jaap Fransen; Tim L Jansen; Tuhina Neogi; H Ralph Schumacher; William J Taylor Journal: Rheumatology (Oxford) Date: 2013-04-22 Impact factor: 7.580
Authors: Mara A McAdams; Janet W Maynard; Alan N Baer; Anna Köttgen; Sandra Clipp; Josef Coresh; Allan C Gelber Journal: J Rheumatol Date: 2010-12-01 Impact factor: 4.666
Authors: Marie E Holmqvist; Martin Neovius; Jonas Eriksson; Ängla Mantel; Solveig Wållberg-Jonsson; Lennart T H Jacobsson; Johan Askling Journal: JAMA Date: 2012-10-03 Impact factor: 56.272
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Tanica Lyngdoh; Pedro Marques-Vidal; Fred Paccaud; Martin Preisig; Gérard Waeber; Murielle Bochud; Peter Vollenweider Journal: PLoS One Date: 2011-05-20 Impact factor: 3.240
Authors: Yasuhiko Kubota; Kelly R Evenson; Richard F Maclehose; Nicholas S Roetker; Corinne E Joshu; Aaron R Folsom Journal: Med Sci Sports Exerc Date: 2017-08 Impact factor: 5.411