THU0506 Cardiovascular Risk and Endothelial Dysfunction in Patients with Gout: Experience in A Multihospital spanish Group. (15th July 2016)

• Record Type: Journal Article
• Authors: Calvo Aranda, E.; Carriόn, O.; Abdelkader, A.; González, J.; Aramburu, F.; Valero, M.; Rodriguez, S.; Marin, C.; Sangüesa, C.; Amil, I.; Saiz, F.; García de la Peña, P.
• Is Part Of: Annals of the rheumatic diseases. Volume 75(2016)Supplement 2
• Page Start: 375
• Page End: 375
• Publication Date: 2016-07-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-eular.5965
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Several reports have shown the relationship between gout and increased cardiovascular risk (CVR). There is a lack of research in Spain about endothelial and cardiac dysfunction in gout Objectives: Analyze CVR factors in gouty patients in our sample with vascular assessment, cardiological tests and laboratory parameters Methods: Prospective cohort study with collection of clinical data, family history (FH) of gout and cardiovascular disease (CVD), and treatments received (calcium channel antagonists [CCA], ACE inhibitors [ACE-i], angiotensin receptor blokers [ARB], beta blockers [BB] or thiazides. A history of hypertension, diabetes (DM), dyslipidemia (DL), smoking, thrombotic events, ischemic heart disease (IHD) were also collected. Body mass index (BMI), serum uric acid (SUA), sedimentation rate (ESR), conventional/ultrasensitive RCP [cRCP, hsCRP], ferritin, total cholesterol (CHOL) and subtypes (HDLc, LDLc), triglycerides (TG), vitamin D and homocysteine were measured. Patients were referred to Vascular Surgery Department for ultrasound examination with search of carotid plaques and study of intima-media thickness (IMT), and also were to Cardiology Department for echocardiogram (ECHO-CG) and electrocardiogram (ECG) Results: 150 patients, 97% men and 3% women. Average age at time of study and diagnosis: 56 (23–92) and 47 years (15–79), respectively. Age at symptoms onset: 45 years (15–77). 22.5% had tophi and 11.3% urate stones. FH: 42% had gout history and 41% CVD history. Classical CVR factors: hypertension 47.3%; DM-2 4.6%, glucose intolerance 0.6%; DL 56.7% (CHOL: 37, TG: 15, both: 33); smokers 20.6% and quitters 37.6%, 21 pack/year (1–90); 1 patient had suffered stroke; 4 thrombosis; 17 IHD (11 angina, 6 myocardial infarction). 75% overweight/obesity, BMI 28 (19–40). Analytical parameters: ESR 10 mm/h (1–68), hs-CRP 2.7 mg/dL (0.1–57.7), c-CRP 2.3 mg/L (0–14.8); SUA 6.9 mg/dL (2.4–11.8); ferritin 259 ng/ml (11–2000); COL-t: 187 mg/dL (102–321, 6 not collected [NC]), HDLc 47 mg/dL (15–88; 22 NC), LDLc 113 mg/dL (15–248) TG 145 mg/dL (53–603); vitamin D 24.7 ng/mL (5.6–23.6; 28.6% <20); homocysteine 24.7 mmol/L (4–40; 32% >15 mmol/L). ECHO-CG: 6 valvular disease, 13 left ventricular hypertrophy, 45 had >1 finding, 5 NC. ECG was normal in 79 patients; 9 right bundle branch block (BBB), 1 left BBB, 4 IHD signs, 2 repolarization abnormalities and 6 arrhythmia; 13 had ≥2 findings, 9 showed other findings, 54 NC. Vascular examination: carotid IMT greater than corresponding adjusted by age group in 75% and 79% of patients (right and left, respectively); both: 65%. Carotid plaques 23%. Treatments: ACA 2.6%, ACE-i 2%, ARB 4.6%, BB 2%, thiazides 3.3% Conclusions: 75% of our patients have overweight/obesity. High percentage of subjects with hyperhomocysteinemia and/or vitamin D deficiency. Marked prevalence of increased IMT and carotid plaques, and outstanding number of cardiac abnormalities in ECHO-G/ECG. Further statistical studies will quantify the value of these early findings, that seem very relevant References: Feig DI, et al. Uric acid and cardiovascular risk. N Engl J Med. 2008;359(17):1811–21 Çukurova S, et al.Subclinical atherosclerosis in gouty arthritis patients: a comparative study. Rheumatol Int. 2012;32(6):1769–73 Disclosure of Interest: None declared