Gout Is Prevalent but Under-Registered Among Patients With Cardiovascular Events: A Field Study
Irene Calabuig, Miguel Gómez-Garberí, Mariano Andrés
Abstract
Objectives: Gout is an independent cardiovascular (CV) risk factor with significant morbidity and mortality. This work aimed to estimate the prevalence of gout, characteristics and management in a hospitalised population for CV disease, a topic that remains to be defined. Methods: Observational, descriptive, cross-sectional study, performed in patients admitted for CV events selected following a non-consecutive, systematic sampling. Data about CV disease and gout were obtained from face-to-face interviews and patients’ records. Gout diagnosis was established by 2015 ACR/EULAR clinical classification criteria. Registration rate of gout was assessed by auditing patients’ records and hospital discharge reports from the units of interest in the previous two years. To predict the presence of gout, multiple logistic regression was used. Results: 266 participants were recruited, mean aged 68 years, predominantly males (69.9%) and Caucasians (96.6%). Gout was identified in 40/266 individuals; thus, prevalence was 15.0% (95%CI 10.9-19.2%). In 35% of cases, the diagnosis was absent from records. Gout was found in 1.4-2.6% of hospital discharge reports of CV events, also indicating under-registration. At admission, only half of the gout patients were on urate-lowering therapy, 38.5% of them on therapeutic urate levels. Hyperuricemia was the only independent predictor of gout (odds ratio 2.9; 95%CI 1.2-7.1); in absence of urate levels, chronic kidney disease independently predicted it (odds ratio 3.0; 95%CI 1.4-6.6). Conclusion: Gout is highly prevalent among patients admitted for CV events, with significant unawareness and suboptimal management, despite being a well-established independent CV risk factor.