Presence of Tophi is a Predictive Factor of Arterial Stiffness in Patients with Gout

Overview

Journal Rheumatol Int

Specialty Rheumatology

Date 2019 Jun 3

PMID 31154472

Authors

Wooseong Jeong

Seung-Jae Joo

Jinsoek Kim

Jae-Geun Lee

Joon Hyouk Choi

Affiliations

Soon will be listed here.

Abstract

The objective of this study is to determine whether the presence of tophi could predict an increase in arterial stiffness. Between June 2017 and June 2018, the augmentation index (AI) was measured using SphygmoCor for patients with gout who visited the Jeju National University Hospital in South Korea. Patients were divided into the following groups: group with tophi and group without tophi. Medical records, laboratory data, and AI were retrospectively analyzed. One hundred and twenty patients with gout or participated in the study, with most (96.7%) of the patients being male. The mean duration of the disease was 7.0 years. At the time of the examination, 99 patients (82.5%) were treated with a uric acid-lowering agent. Of the total patients, 24 (19.7%) had tophi. Patients with tophi were significantly older (60.2 ± 11.6 years vs. 53.8 ± 13.0 years, p = 0.031), had longer disease duration (13.0 ± 6.5 years vs 5.5 ± 5.4 years, p < 0.001), and higher AI@75 (28.7 ± 7.8 vs 20.9 ± 10.0, p = 0.001) than those without tophi. In the multiple linear regression analysis, tophi was shown to be a significant predictor of high AI (p = 0.040). The presence of tophi is a predictor of increased arterial stiffness in patients with gout. Therefore, more strict control of cardiovascular disease risk factors is needed in the treatment of patients with tophi.

References

Quach C, Galen B . HLA-B*5801 Testing to Prevent Allopurinol Hypersensitivity Syndrome: A Teachable Moment. JAMA Intern Med. 2018; 178(9):1260-1261. DOI: 10.1001/jamainternmed.2018.3556. View

Kuo C, See L, Luo S, Ko Y, Lin Y, Hwang J . Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology (Oxford). 2009; 49(1):141-6. DOI: 10.1093/rheumatology/kep364. View

Vlachopoulos C, Xaplanteris P, Vyssoulis G, Bratsas A, Baou K, Tzamou V . Association of serum uric acid level with aortic stiffness and arterial wave reflections in newly diagnosed, never-treated hypertension. Am J Hypertens. 2010; 24(1):33-9. DOI: 10.1038/ajh.2010.111. View

Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M . Higher serum uric acid is associated with increased arterial stiffness in Japanese individuals. Atherosclerosis. 2006; 192(1):131-7. DOI: 10.1016/j.atherosclerosis.2006.04.016. View

Perez-Ruiz F, Martinez-Indart L, Carmona L, Herrero-Beites A, Pijoan J, Krishnan E . Tophaceous gout and high level of hyperuricaemia are both associated with increased risk of mortality in patients with gout. Ann Rheum Dis. 2013; 73(1):177-82. DOI: 10.1136/annrheumdis-2012-202421. View

Clarson L, Chandratre P, Hider S, Belcher J, Heneghan C, Roddy E . Increased cardiovascular mortality associated with gout: a systematic review and meta-analysis. Eur J Prev Cardiol. 2013; 22(3):335-43. PMC: 4361356. DOI: 10.1177/2047487313514895. View

Yang L, Qin B, Zhang X, Chen Y, Hou J . Association of central blood pressure and cardiovascular diseases in diabetic patients with hypertension. Medicine (Baltimore). 2017; 96(42):e8286. PMC: 5662393. DOI: 10.1097/MD.0000000000008286. View

Vlachopoulos C, Aznaouridis K, Stefanadis C . Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010; 55(13):1318-27. DOI: 10.1016/j.jacc.2009.10.061. View

Saijo Y, Utsugi M, Yoshioka E, Horikawa N, Sato T, Gong Y . Relationships of C-reactive protein, uric acid, and glomerular filtration rate to arterial stiffness in Japanese subjects. J Hum Hypertens. 2005; 19(11):907-13. DOI: 10.1038/sj.jhh.1001913. View

10.

Chien K, Hsu H, Sung F, Su T, Chen M, Lee Y . Hyperuricemia as a risk factor on cardiovascular events in Taiwan: The Chin-Shan Community Cardiovascular Cohort Study. Atherosclerosis. 2005; 183(1):147-55. DOI: 10.1016/j.atherosclerosis.2005.01.018. View

11.

Krishnan E, Svendsen K, Neaton J, Grandits G, Kuller L . Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med. 2008; 168(10):1104-10. DOI: 10.1001/archinte.168.10.1104. View

12.

Rott K, Agudelo C . Gout. JAMA. 2003; 289(21):2857-60. DOI: 10.1001/jama.289.21.2857. View

13.

Roman M, Devereux R, Kizer J, Lee E, Galloway J, Ali T . Central pressure more strongly relates to vascular disease and outcome than does brachial pressure: the Strong Heart Study. Hypertension. 2007; 50(1):197-203. DOI: 10.1161/HYPERTENSIONAHA.107.089078. View

14.

Fantin F, Mattocks A, Bulpitt C, Banya W, Rajkumar C . Is augmentation index a good measure of vascular stiffness in the elderly?. Age Ageing. 2006; 36(1):43-8. DOI: 10.1093/ageing/afl115. View

15.

Choi H, Mount D, Reginato A . Pathogenesis of gout. Ann Intern Med. 2005; 143(7):499-516. DOI: 10.7326/0003-4819-143-7-200510040-00009. View

16.

Choi H, Curhan G . Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007; 116(8):894-900. DOI: 10.1161/CIRCULATIONAHA.107.703389. View

17.

Kuo C, Grainge M, Zhang W, Doherty M . Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015; 11(11):649-62. DOI: 10.1038/nrrheum.2015.91. View

18.

Tsai W, Huang Y, Lin C, Li W, Lee C, Chen J . Uric acid is an independent predictor of arterial stiffness in hypertensive patients. Heart Vessels. 2009; 24(5):371-5. DOI: 10.1007/s00380-008-1127-9. View

19.

Headley S, Germain M, Wood R, Joubert J, Milch C, Evans E . Short-term aerobic exercise and vascular function in CKD stage 3: a randomized controlled trial. Am J Kidney Dis. 2014; 64(2):222-9. PMC: 4112010. DOI: 10.1053/j.ajkd.2014.02.022. View

20.

Mehta T, Nuccio E, McFann K, Madero M, Sarnak M, Jalal D . Association of Uric Acid With Vascular Stiffness in the Framingham Heart Study. Am J Hypertens. 2015; 28(7):877-83. PMC: 4542908. DOI: 10.1093/ajh/hpu253. View