Fu-Shun Yen1, Chih-Cheng Hsu2,3,4, Hsin-Lun Li5,6, James Cheng-Chung Wei7,8,9, Chii-Min Hwu10,11. 1. Dr. Yen's Clinic, Taoyuan City, Taiwan. 2. Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan. 3. Department of Health Services Administration, China Medical University, Taichung, Taiwan. 4. Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan. 5. Management Office for Health Data, China Medical University, Taichung, Taiwan. 6. Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan. 7. Institute of Medicine, Chung Shan Medical University, Taichung City, Taiwan. 8. Department of Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan. 9. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. 10. Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. 11. Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Abstract
OBJECTIVES: Although studies have demonstrated the association of hyperuricemia with cardiovascular (CV) diseases, few have explored the effect of urate-lowering therapy (ULT) on the incidence of CV diseases. Therefore, we compared the risks of hospitalized coronary artery disease (CAD), stroke, heart failure (HF), and all-cause mortality between ULT users and nonusers among patients with gout. METHODS: We performed this retrospective cohort study using Taiwan's population-based National Health Insurance Research Database. In total, 5218 patients with gout were included from 2000 to 2012. We compared the incidence rates (IRs) of hospitalized CAD, stroke, HF, and all-cause mortality between ULT users and matched nonusers. RESULTS: The IRs of hospitalized stroke were 0.6 and 1.0 per 100 person-years for ULT users and nonusers, respectively, after adjusting for age, sex, residence, comorbidities, and medications. ULT users showed lower adjusted hazard ratios (aHR) for hospitalized stroke (aHR: 0.52, p < 0.001) and all-cause mortality (aHR: 0.6, p = 0.02) than nonusers. Subgroup analyses revealed that uricosuric agents and xanthine oxidase inhibitors were significantly associated with lower risks of hospitalized stroke and all-cause mortality, respectively. The effect of uricosuric agents on the decrease in hospitalized stroke risk indicated a dose-response relationship. CONCLUSIONS: Our study showed lower risks of hospitalized stroke and all-cause mortality in ULT users than in nonusers among patients with gout. Therefore, patients with gout may receive ULT to mitigate the risks of hospitalized stroke and mortality.
OBJECTIVES: Although studies have demonstrated the association of hyperuricemia with cardiovascular (CV) diseases, few have explored the effect of urate-lowering therapy (ULT) on the incidence of CV diseases. Therefore, we compared the risks of hospitalized coronary artery disease (CAD), stroke, heart failure (HF), and all-cause mortality between ULT users and nonusers among patients with gout. METHODS: We performed this retrospective cohort study using Taiwan's population-based National Health Insurance Research Database. In total, 5218 patients with gout were included from 2000 to 2012. We compared the incidence rates (IRs) of hospitalized CAD, stroke, HF, and all-cause mortality between ULT users and matched nonusers. RESULTS: The IRs of hospitalized stroke were 0.6 and 1.0 per 100 person-years for ULT users and nonusers, respectively, after adjusting for age, sex, residence, comorbidities, and medications. ULT users showed lower adjusted hazard ratios (aHR) for hospitalized stroke (aHR: 0.52, p < 0.001) and all-cause mortality (aHR: 0.6, p = 0.02) than nonusers. Subgroup analyses revealed that uricosuric agents and xanthine oxidase inhibitors were significantly associated with lower risks of hospitalized stroke and all-cause mortality, respectively. The effect of uricosuric agents on the decrease in hospitalized stroke risk indicated a dose-response relationship. CONCLUSIONS: Our study showed lower risks of hospitalized stroke and all-cause mortality in ULT users than in nonusers among patients with gout. Therefore, patients with gout may receive ULT to mitigate the risks of hospitalized stroke and mortality.
Authors: Karel H van der Pol; Kimberley E Wever; Mariette Verbakel; Frank L J Visseren; Jan H Cornel; Gerard A Rongen Journal: PLoS One Date: 2021-12-02 Impact factor: 3.240
Authors: Ching-Lan Cheng; Chi-Tai Yen; Chien-Chou Su; Cheng-Han Lee; Chien-Huei Huang; Yea-Huei Kao Yang Journal: Front Cardiovasc Med Date: 2022-08-11