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Cause-Specific Mortality in Gout : Novel Findings of Elevated Risk of Non–Cardiovascular-Related Deaths

Vargas-Santos, Ana Beatriz ; Neogi, Tuhina ; da Rocha Castelar-Pinheiro, Geraldo ; Kapetanovic, Meliha C. LU and Turkiewicz, Aleksandra LU (2019) In Arthritis and Rheumatology 71(11). p.1935-1942
Abstract

Objective: To examine cause-specific mortality beyond cardiovascular diseases (CVDs) in patients with gout compared to the general population. Methods: We included all residents of Skåne (Sweden) age ≥18 years in the year 2002. Using the Skåne Healthcare Register, we identified subjects with a new diagnosis of gout (2003–2013) and matched each person with gout with 10 comparators free of gout, by age and sex. We used information on the underlying cause of death from the Swedish Cause of Death Register (through December 31, 2014) to estimate hazard ratios (HRs, with 95% confidence intervals [95% CIs]) of mortality for specific causes of death in a multi-state Cox model, with adjustment for potential confounders. Results: Among 832,258... (More)

Objective: To examine cause-specific mortality beyond cardiovascular diseases (CVDs) in patients with gout compared to the general population. Methods: We included all residents of Skåne (Sweden) age ≥18 years in the year 2002. Using the Skåne Healthcare Register, we identified subjects with a new diagnosis of gout (2003–2013) and matched each person with gout with 10 comparators free of gout, by age and sex. We used information on the underlying cause of death from the Swedish Cause of Death Register (through December 31, 2014) to estimate hazard ratios (HRs, with 95% confidence intervals [95% CIs]) of mortality for specific causes of death in a multi-state Cox model, with adjustment for potential confounders. Results: Among 832,258 persons, 19,497 had a new diagnosis of gout (32% women) and were matched with 194,947 comparators. Subjects with gout had higher prevalence of chronic kidney disease, metabolic disease, and CVD. Gout was associated with 17% increased hazard of all-cause mortality overall (HR 1.17 [95% CI 1.14–1.21]), 23% in women (HR 1.23 [95% CI 1.17–1.30]), and 15% in men (HR 1.15 [95% CI 1.10–1.19]). In terms of cause-specific mortality, the strongest associations were seen in the relationship of gout to the risk of death due to renal disease (HR 1.78 [95% CI 1.34–2.35]), diseases of the digestive system (HR 1.56 [95% 1.34–1.83]), CVD (HR 1.27 [95% CI 1.22–1.33]), infections (HR 1.20 [95% CI 1.06–1.35]), and dementia (HR 0.83 [95% CI 0.72–0.97]). Conclusion: Several non-CV causes of mortality are increased in persons with gout, emphasizing the need for improved management of comorbidities.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis and Rheumatology
volume
71
issue
11
pages
8 pages
publisher
John Wiley & Sons
external identifiers
  • pmid:31169353
  • scopus:85073982125
ISSN
2326-5191
DOI
10.1002/art.41008
language
English
LU publication?
yes
id
a9c379a4-e737-4e56-803f-3200705f9f15
date added to LUP
2019-11-06 14:05:32
date last changed
2019-12-10 08:16:36
@article{a9c379a4-e737-4e56-803f-3200705f9f15,
  abstract     = {<p>Objective: To examine cause-specific mortality beyond cardiovascular diseases (CVDs) in patients with gout compared to the general population. Methods: We included all residents of Skåne (Sweden) age ≥18 years in the year 2002. Using the Skåne Healthcare Register, we identified subjects with a new diagnosis of gout (2003–2013) and matched each person with gout with 10 comparators free of gout, by age and sex. We used information on the underlying cause of death from the Swedish Cause of Death Register (through December 31, 2014) to estimate hazard ratios (HRs, with 95% confidence intervals [95% CIs]) of mortality for specific causes of death in a multi-state Cox model, with adjustment for potential confounders. Results: Among 832,258 persons, 19,497 had a new diagnosis of gout (32% women) and were matched with 194,947 comparators. Subjects with gout had higher prevalence of chronic kidney disease, metabolic disease, and CVD. Gout was associated with 17% increased hazard of all-cause mortality overall (HR 1.17 [95% CI 1.14–1.21]), 23% in women (HR 1.23 [95% CI 1.17–1.30]), and 15% in men (HR 1.15 [95% CI 1.10–1.19]). In terms of cause-specific mortality, the strongest associations were seen in the relationship of gout to the risk of death due to renal disease (HR 1.78 [95% CI 1.34–2.35]), diseases of the digestive system (HR 1.56 [95% 1.34–1.83]), CVD (HR 1.27 [95% CI 1.22–1.33]), infections (HR 1.20 [95% CI 1.06–1.35]), and dementia (HR 0.83 [95% CI 0.72–0.97]). Conclusion: Several non-CV causes of mortality are increased in persons with gout, emphasizing the need for improved management of comorbidities.</p>},
  author       = {Vargas-Santos, Ana Beatriz and Neogi, Tuhina and da Rocha Castelar-Pinheiro, Geraldo and Kapetanovic, Meliha C. and Turkiewicz, Aleksandra},
  issn         = {2326-5191},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {1935--1942},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis and Rheumatology},
  title        = {Cause-Specific Mortality in Gout : Novel Findings of Elevated Risk of Non–Cardiovascular-Related Deaths},
  url          = {http://dx.doi.org/10.1002/art.41008},
  doi          = {10.1002/art.41008},
  volume       = {71},
  year         = {2019},
}