Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Gout Linked with Myocardial Infarction in Elderly

Arthritis Res Ther; 2018 Jun 1; Singh, et al

Gout was independently associated with a higher risk of myocardial infarction (MI) in the elderly, aged ≥65 years, according to a recent study. Researchers assessed the 2006–2012 Medicare 5% claims data for the association of gout at baseline with the occurrence of a new (incident) MI during follow-up (no diagnosis of MI in the baseline period of at least 1 year), adjusting for patient demographics, medical comorbidity (Charlson-Romano index), and commonly used cardiovascular and gout medications, in a Cox proportional hazards model. They found:

  • In a cohort of 1,733,613 eligible people, 14,279 developed incident MI: 13,029 MIs in people without gout and 1,250 MIs in those with gout, with crude incident rates of 1.3 vs 4.1 per 1,000 person-years, respectively.
  • In multivariable-adjusted analyses, gout was significantly associated with a higher hazard of incident MI, with HR of 2.08.
  • Risk was minimally attenuated in sensitivity analyses that replaced the continuous Charlson-Romano index score with a categorical score or individual comorbidities, or expanding to a more sensitive diagnostic algorithm for incident MI, or additionally adjusting for obesity.


Singh JA, Cleveland JD. Gout and the risk of myocardial infarction in older adults: A study of Medicare recipients. Arthritis Res Ther. 2018;20(1):109. doi:10.1186/s13075-018-1606-z.