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Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality

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dc.contributor.author Pérez Ruiz, Fernando
dc.contributor.author Richette, Pascal
dc.contributor.author Stack, Austin G.
dc.contributor.author Gurunath, Ravichandra Karra
dc.contributor.author García de Yébenes, Ma Jesus
dc.contributor.author Carmona, Loreto
dc.date.accessioned 2019-10-30T15:22:17Z
dc.date.available 2019-10-30T15:22:17Z
dc.date.issued 2019
dc.identifier.uri http://hdl.handle.net/10344/8191
dc.description peer-reviewed en_US
dc.description.abstract Objective To determine the impact of achieving serum uric acid (sUA) of <0.36 mmol/L on overall and cardiovascular (CV) mortality in patients with gout. Methods Prospective cohort of patients with gout recruited from 1992 to 2017. Exposure was defined as the average sUA recorded during the first year of followup, dichotomised as ≤ or >0.36 mmol/L. Bivariate and multivariate Cox proportional hazards models were used to determine mortality risks, expressed HRs and 95% CIs. Results Of 1193 patients, 92% were men with a mean age of 60 years, 6.8 years’ disease duration, an average of three to four flares in the previous year, a mean sUA of 9.1 mg/dL at baseline and a mean follow-up 48 months; and 158 died. Crude mortality rates were significantly higher for an sUA of ≥0.36 mmol/L, 80.9 per 1000 patient-years (95% CI 59.4 to 110.3), than for an sUA of <0.36 mmol/L, 25.7 per 1000 patient-years (95% CI 21.3 to 30.9). After adjustment for age, sex, CV risk factors, previous CV events, observation period and baseline sUA concentration, an sUA of ≥0.36 mmol/L was associated with elevated overall mortality (HR=2.33, 95% CI 1.60 to 3.41) and CV mortality (HR=2.05, 95% CI 1.21 to 3.45). Conclusions Failure to reach a target sUA level of 0.36 mmol/L in patients with hyperuricaemia of gout is an independent predictor of overall and CV-related mortality. Targeting sUA levels of <0.36 mmol/L should be a principal goal in these high-risk patients in order to reduce CV events and to extend patient survival. en_US
dc.language.iso eng en_US
dc.publisher BMJ Publishing Group en_US
dc.relation.ispartofseries RMD Open;5 (2), e001015
dc.relation.uri http://dx.doi.org/10.1136/rmdopen-2019-001015
dc.subject cardiovascular mortality en_US
dc.title Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1136/rmdopen-2019-001015
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US
dc.internal.rssid 2931822


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