THU0506 Cardiovascular Risk and Endothelial Dysfunction in Patients with Gout: Experience in A Multihospital spanish Group
Authors: E. Calvo Aranda, O. Carriόn, A. Abdelkader, J. González, F. Aramburu, M. Valero, S. Rodriguez, C. Marin, C. Sangüesa, I. Amil, F. Saiz, P. García de la Peña
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> 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 <h3>Objectives</h3> Analyze CVR factors in gouty patients in our sample with vascular assessment, cardiological tests and laboratory parameters <h3>Methods</h3> 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) <h3>Results</h3> 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% &lt;20); homocysteine 24.7 mmol/L (4–40; 32% &gt;15 mmol/L). ECHO-CG: 6 valvular disease, 13 left ventricular hypertrophy, 45 had &gt;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% <h3>Conclusions</h3> 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 <h3>References</h3> 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 <h3>Disclosure of Interest</h3> None declared