Men with a history of gouty arthritis have a significantly higher risk of developing an acute myocardial infarction, reported Dr. Eswar Krishnan of the University of Pittsburgh, and his associates.
“This study is the first to show that in men with no previous history of coronary artery disease, gouty arthritis is a significant independent correlate of subsequent acute myocardial infarction,” they said.
The results revealed a significantly greater number of acute MI events in men with gout (odds ratio, 1.26). The study also showed that hyperuricemia is an independent risk factor for acute MI (OR, 1.11).
The finding comes from an evaluation of the Multiple Risk Factor Intervention Trial (MRFIT) data. Researchers of MRFIT, a randomized controlled trial of 12,866 men with a mean age of 46 years, followed the group prospectively for approximately 6.5 years. Initial evaluation included blood pressure and cholesterol measurements (Arthritis Rheum. 2006;54:2688–96).
Men with a history of diabetes, acute MI, a high cholesterol level (350 mg/dL or higher), a diastolic blood pressure of greater than 115 mm Hg, and body weight greater than 150% of desirable weight were excluded. In the original trial, the participants were randomized to a special intervention program that promoted smoking cessation and blood pressure and cholesterol reduction versus usual care, Dr. Krishnan and his associates reported.
The researchers used a two-part definition of gout. Participants had to answer affirmatively when asked if they had ever been told by a physician that they had gout. They also had to have a uric acid level of greater than 7.0 mg/dL on at least four visits. This definition was used because obtaining joint fluid samples on all participants was not within the trial's scope.