Urate Deposits in Blood Vessels may Increase CV Risk in Gout Patients, claims study

A recent research published in the Rheumatology journal identified a significant link between cardiovascular monosodium urate deposits and an increased likelihood of major cardiovascular events in patients with gout and hyperuricemia. The findings were derived from a retrospective cohort study that suggest the association of gout with the presence of urate deposits which could be a pivotal marker for assessing heart disease risks in these patients.

The study analyzed data from 189 individuals who underwent dual energy computed tomography scans of the thorax and an affected limb, in the patients suspected of gout, from June 1, 2012 to December 5, 2019. The group included a total of 131 gout patients, 40 patients with hyperuricemia (elevated uric acid levels without gout symptoms) and 18 controls.

The findings revealed that 45% of the patients had detectable cardiovascular monosodium urate deposits. This group had higher levels of serum acute phase reactants which is a marker of inflammation and uric acid, also higher calcium scores on their CT scans that indicates the presence of more substantial atherosclerotic plaque. These patients also underwent a increased rate of major adverse cardiac events. Over the median follow-up period of 33 months, 25.9% of patients with urate deposits underwent such events when compared to only 12.5% of the individuals without these deposits.

The study highlights the presence of urate deposits was associated with a doubling of risk for major cardiac events (odds ratio 2.4; p=0.018). This finding suggests that urate deposits might be used as an additional factor for risk stratification in patients with gout or hyperuricemia.

The risk assessment for heart diseases in gout and hyperuricemia patients is often based on classical cardiovascular risk scores that include factors like cholesterol levels, smoking status and blood pressure. These scores sometimes do not adequately predict risk in these groups. The inclusion of advanced imaging techniques like dual energy computed tomography could improve the prediction of cardiovascular risk that makes it possible for earlier intervention and tailored treatment strategies.

Findings like these are very crucial for enhancing the outcomes through more personalized healthcare approaches. The research team hopes that these results will prompt further studies and eventually lead to updates in clinical guidelines for the management of patients with higher uric acid levels and suspected cardiovascular disease.

Source:

Held, J., Schwabl, C., Haschka, D., Maier, S., Feuchtner, G., Widmann, G., Duftner, C., Weiss, G., & Klauser, A. (2024). Major cardiovascular events in patients with cardiovascular monosodium urate deposits in atherosclerotic plaques. In Rheumatology. Oxford University Press (OUP). https://doi.org/10.1093/rheumatology/keae240