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Background: Gout is a disorder of uric acid metabolism and often presents as acute severe joint pain. However, recent studies have highlighted systemic complications of associated hyperuricemia in patients with gout, including possible increased risk of cardiovascular comorbidities. On the other hand, it is well-recognized that patients with rheumatoid arthritis (RA) have an increased risk of thrombotic cardiovascular events.
Objectives: To study hospitalizations for acute myocardial infarction in patients with gout in the United States (US), and compare with hospitalizations in RA patients.
Methods: The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of insurance status. We examined all inpatient hospitalizations in NIS in 2005 with a primary or secondary diagnosis of gout, and compared them to total all-cause US hospitalizations. We identified all inpatient hospitalizations with a primary diagnosis of AMI and a secondary diagnosis of gout or RA. US population estimates and projections for the resident US population were obtained from the US Census Bureau.
Results: There were 39,163,834 million all-cause hospitalizations in 295.9 million person-years of observation in 2005 (132.4 hospitalizations per 1,000 person-years). During this time period, 445,823 hospitalizations occurred in patients with gout (150.7 per 100,000 person-years; 1.14% of all-cause hospitalizations). Hospitalizations in gout patients accounted for over 2.3 million hospital days at a total national cost of over US$11.2 billion. There were 11,394 hospitalizations for acute myocardial infarction in patients with gout (2.6% of all hospitalizations), of which 4.1% were fatal. These hospitalizations resulted in 59,812 total hospital days at a total cost of $475.2 million. In contrast, there were 358,573 all-cause hospitalizations in patients with RA, of which 7,220 were acute myocardial infarctions (2.01% of total, p<0.0001 compared with gout, 5.4% fatal). Conclusion: Acute myocardial infarction hospitalizations form a much larger percentage of gout hospitalizations compared to their frequency in RA. This calls for an increase need for identification and management of serious cardiovascular co-morbid conditions in patients with gout. Our findings have major implications for screening, early diagnosis, prevention and clinical management of coronary artery disease in patients with gout.
Objectives: To study hospitalizations for acute myocardial infarction in patients with gout in the United States (US), and compare with hospitalizations in RA patients.
Methods: The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of insurance status. We examined all inpatient hospitalizations in NIS in 2005 with a primary or secondary diagnosis of gout, and compared them to total all-cause US hospitalizations. We identified all inpatient hospitalizations with a primary diagnosis of AMI and a secondary diagnosis of gout or RA. US population estimates and projections for the resident US population were obtained from the US Census Bureau.
Results: There were 39,163,834 million all-cause hospitalizations in 295.9 million person-years of observation in 2005 (132.4 hospitalizations per 1,000 person-years). During this time period, 445,823 hospitalizations occurred in patients with gout (150.7 per 100,000 person-years; 1.14% of all-cause hospitalizations). Hospitalizations in gout patients accounted for over 2.3 million hospital days at a total national cost of over US$11.2 billion. There were 11,394 hospitalizations for acute myocardial infarction in patients with gout (2.6% of all hospitalizations), of which 4.1% were fatal. These hospitalizations resulted in 59,812 total hospital days at a total cost of $475.2 million. In contrast, there were 358,573 all-cause hospitalizations in patients with RA, of which 7,220 were acute myocardial infarctions (2.01% of total, p<0.0001 compared with gout, 5.4% fatal). Conclusion: Acute myocardial infarction hospitalizations form a much larger percentage of gout hospitalizations compared to their frequency in RA. This calls for an increase need for identification and management of serious cardiovascular co-morbid conditions in patients with gout. Our findings have major implications for screening, early diagnosis, prevention and clinical management of coronary artery disease in patients with gout.
G. Singh, TAP, 2; Takeda, 2; Pfizer, 2; Novartis, 2; Astra-Zeneca, 2; Pfizer, 8; S. Vadhavkar, None; A. Mannalithara, None; A. Mithal, None; O. Dabbous, TAP, 3; G. Triadafilopoulos, Pfizer, 5; Pfizer, 8; Astra-Zeneca, 8.