Abstract P162: Gout and Risk for Incident Heart Failure, Coronary Heart Disease and Stroke: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Abstract

Background: Gout has been associated with a higher risk for coronary heart disease (CHD) and stroke in some but not all prior studies. There are few data available on the risk for incident heart failure associated with gout. Objective: To compare the incidence of heart failure, CHD and stroke among adults with versus without gout. Methods: We used data from 5,499 black and white REasons for Geographic and Racial Differences in Stroke (REGARDS) study participants >65 years of age with Medicare coverage without a history of heart failure, CHD or stroke at baseline in 2003-2007. Gout was defined by (1) ≥1 inpatient claim or ≥2 outpatient or carrier claims on separate days with an ICD-9 diagnosis code for gout (274.x) in Medicare prior to each participant’s baseline study visit, or (2) use of allopurinol, colchicine or probenecid based on a baseline medication inventory. REGARDS study participants were followed through December 31, 2015 for heart failure, CHD, and stroke events, which were adjudicated. Results: Among participants included in the current analysis (mean age 72 years, 45% male, 31% black), 223 (4%) had gout. The incidence of heart failure and CHD was higher, while the incidence of stroke was similar, among participants with versus without gout ( Figure ). After adjustment for sociodemographic and cardiovascular risk factors, hazard ratios comparing participants with versus without gout were 2.41 (95%CI 1.60, 3.64) for heart failure, 1.41 (0.96, 2.07) for CHD and 0.96 (0.58, 1.59) for stroke. There was no statistically significant effect modification by race or gender. In a sensitivity analysis defining gout only based on Medicare diagnosis codes, multivariable-adjusted hazard ratios for heart failure, CHD and stroke associated with gout were 2.25 (95%CI 1.41, 3.59), 1.26 (0.79, 1.99) and 0.83 (0.45, 1.52), respectively. Conclusion: After accounting for sociodemographic and cardiovascular risk factors, gout remains strongly associated with incident heart failure but not with incident CHD or stroke.