Work

Annual gout flare frequency as a marker of sustained cardiovascular risk: a clinical threshold for risk stratification

Year: 2026

Type: article

Abstract: OBJECTIVES: We examined whether annual gout flare frequency, as a marker of cumulative inflammatory burden, predicts long-term major adverse cardiovascular events (MACEs). METHODS: Using the TriNetX Global Collaborative Network, we identified adults with a first EHR-recorded treated gout flare in 2017. Using a 12-month landmark exposure window, patients were classified as low (≤3), moderate (4-6) or high (≥7) flares/year. Modified MACE (myocardial infarction, stroke, heart failure) was followed from the landmark. Groups were compared using 1:1 propensity score matching. A sensitivity analysis applied a stricter flare definition (gout diagnosis with colchicine, corticosteroid or intra-articular injection within 0-3 days; NSAIDs excluded). RESULTS: Among 44 705 patients, matching produced balanced cohorts (high vs low, 13 179 pairs; moderate vs low, 9700 pairs). A graded dose-response was observed: at 7 years, MACE risk was higher in the high (RR 1.45; 95% CI 1.37-1.53) and moderate (RR 1.24; 1.15-1.33) groups vs low. Heart failure risk was elevated in both the groups (HR 1.27 [high]; 1.17 [moderate]); stroke and myocardial infarction were elevated only in the high group (7-year HR 1.28 each), with stroke significant from 3 years. Findings were consistent under the stricter sensitivity definition (7-year MACE HR 1.19 [high] and 1.12 [moderate]). CONCLUSION: Annual gout flare frequency is a graded marker of sustained cardiovascular risk. Heart failure risk rises with both moderate and high burden, whereas atherothrombotic events emerge predominantly with high-flare frequency, suggesting they require greater cumulative inflammatory exposure.

Source: Lara D. Veeken

DOI: 10.1093/rheumatology/keag370

Authors: Kuei-Ting Tung, Solomon Chih-Cheng Chen, Chun Lee

Institutions: Chia-Yi Christian Hospital, Taipei Medical University

Language: English

Topic: Gout, Hyperuricemia, Uric Acid

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,597