Association Between Gout and Aortic Stenosis

作者：Chang Kevin; Yokose Chio; Tenner Craig; Oh Cheongeun; Donnino Robert; Choy Shan Alana; Pike Virginia C; Shah Binita D; Lorin Jeffrey D; Krasnokutsky Svetlana; Sedlis Steven P; Pillinger Michael H

来源：American Journal of Medicine, 2017, 130(2): 230.e1.

DOI：10.1016/j.amjmed.2016.09.005

• Aortic stenosis
• Gout
• Valvular heart disease

BACKGROUND: An independent association between gout and coronary artery disease is well established. The relationship between gout and valvular heart disease, however, is unclear. The aim of this study was to assess the association between gout and aortic stenosis.
METHODS: We performed a retrospective case-control study. Aortic stenosis cases were identified through a review of outpatient transthoracic echocardiography (TTE) reports. Age-matched controls were randomly selected from patients who had undergone TTE and did not have aortic stenosis. Charts were reviewed to identify diagnoses of gout and the earliest dates of gout and aortic stenosis diagnosis.
RESULTS: Among 1085 patients who underwent TTE, 112 aortic stenosis cases were identified. Cases and nonaortic stenosis controls (n = 224) were similar in age and cardiovascular comorbidities. A history of gout was present in 21.4% (n = 24) of aortic stenosis subjects compared with 12.5% (n = 28) of controls (unadjusted odds ratio 1.90, 95% confidence interval 1.05-3.48, P =.038). Multivariate analysis retained significance only for gout (adjusted odds ratio 2.08, 95% confidence interval 1.00-4.32, P =.049). Among subjects with aortic stenosis and gout, gout diagnosis preceded aortic stenosis diagnosis by 5.8 +/- 1.6 years. The age at onset of aortic stenosis was similar among patients with and without gout (78.7 +/- 1.8 vs 75.8 +/- 1.0 years old, P =.16).
CONCLUSIONS: Aortic stenosis patients had a markedly higher prevalence of precedent gout than agematched controls. Whether gout is a marker of, or a risk factor for, the development of aortic stenosis remains uncertain. Studies investigating the potential role of gout in the pathophysiology of aortic stenosis are warranted and could have therapeutic implications. Published by Elsevier Inc.

• 出版日期2017-2