Per Wändell1, Axel C Carlsson1,2, Jan Sundquist3,4,5, Kristina Sundquist3,4,5. 1. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden. 2. Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden. 3. Center for Primary Health Care Research, Lund University, Malmö, Sweden. 4. Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 5. Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan.
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 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. 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 CHA2DS2-VASc without gout included.
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 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. 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 CHA2DS2-VASc without gout included.
Authors: Seo Young Kim; James P Guevara; Kyoung Mi Kim; Hyon K Choi; Daniel F Heitjan; Daniel A Albert Journal: Arthritis Care Res (Hoboken) Date: 2010-02 Impact factor: 4.794
Authors: Tomas Forslund; Björn Wettermark; Per Wändell; Mia von Euler; Jan Hasselström; Paul Hjemdahl Journal: Int J Cardiol Date: 2013-10-26 Impact factor: 4.164