Singh JA, et al. - The present study is performed to evaluate whether gout is as strong a risk factor as diabetes mellitus (DM) for incident myocardial infarction (MI) and incident stroke. The outcome of this study suggests that gout is a risk equivalent to DM for incident stroke but not for incident MI. Having both gout and DM confers incremental risk compared with DM alone for both incidents MI and stroke.

Methods

• For this research, they designed a retrospective study.
• From 2007 to 2010, they utilized U.S. claims data that included a mix of private and public health plans.
• Four mutually exclusive cohorts were identified: (1) DM only, (2) gout only, (3) gout and DM, and (4) neither gout nor DM.
• Outcomes were acute MI or stroke with hospitalization.
• They compared the age- and sex-specific rates of incident MI and stroke across the four cohorts and evaluated multivariable-adjusted HRs.

Results

• In this study, 232,592 patients had DM, 71,755 had gout, 23,261 had both, and 1,010,893 had neither.
• The incidence of acute MI was lowest in patients with neither gout nor DM, followed by patients with gout alone, DM alone, and both.
• Among men >80 years of age, the respective rates/1000 person-years were 14.6, 25.4, 27.7, and 37.4.
• Similar trends were noted for stroke and in women.
• Compared with DM only, gout was related to a significantly lower adjusted HR of incident MI (HR 0.81, 95% CI 0.76-0.87) but a similar risk of stroke (HR 1.02, 95% CI 0.95-1.10).
• Compared with patients with DM only, patients with both gout and DM had higher HRs for incident MI and stroke (respectively, HR 1.35, 95% CI 1.25–1.47; HR 1.42, 95% CI 1.29-1.56).