SURVIVAL OF GOUT PATIENTS


Cite item

Full Text

Abstract

Aim. To assess survival and lethal outcome risk factors in gout patients. Material and methods. The study included 286 gout patients (246 males, 86% and 49 females, 14%) treated for gout in the Research Institute of Rheumatology from 2001 to 2006. From 2010 to May 2011 a telephone survey was made to obtain information about death of the above examinees. After the survey clinical condition of the dead patients was compared to that of survivors. Results. Of 286 participants of the trial, 38 did not response. By information from the relatives, there were 31 (12.5%) lethal outcomes of 248 patients. A cause of death in 20 patients, irrespective of age, were cardiovascular complications, 6 patients died of cancer, one patient of chronic renal failure, one of infection, one of trauma and 2 of unknown cause. Median of age at death was 62,1 years, median of gout duration 12,8 years. 65% of the deceased patients had risk factors of cardiovascular complications (type 2 diabetes mellitus, coronary heart disease, acute myocardial infarction, stroke, chronic cardiac failure). Median of time since examination in the clinic to death was 4.3 years. Conclusion. Gout patients’ mortality is high. 7-year survival was 85% in high overall mortality. 2/3 patients died of cardiovascular diseases. Survival of gout patients with normuricemia is the same of those with hyperuricemia. A high level of highly sensitive CRP is a factor of poor prognosis (death) for gout patients.

Keywords

About the authors

M S Eliseev

Research Institute of Rheumatology

канд. мед. наук, ст. науч. сотр НИИР РАМН

I S Denisov

Research Institute of Rheumatology

Email: igoruk-81@mail.ru
аспират НИИР РАМН

V G Barskova

Research Institute of Rheumatology

проф., зав. лаб. микрокристаллических артритов НИИ РАМН

References

  1. Насонова В. А., Барскова В. Г. Ранние диагностика и лечение подагры — научно обоснованное требование улучшения трудового и жизненного прогноза больных. Науч.-практ. ревматол. 2004; 1: 5—7.
  2. Елисеев М. С., Барскова В. Г. Метаболический синдром при подагре. Вестн. РАМН 2008; 6: 29—33.
  3. Елисеев М. С. Барскова В. Г. Нарушения углеводного обмена при подагре: частота выявления и клинические особенности. Тер. арх. 2010; 5:50.
  4. Puig J. G., Martinez M. A. Hyperuricemia, gout and the metabolic syndrome. Curr. Opin. Rheumatol. 2008; 20: 187—191.
  5. Cameron J. S., Simmonds H. A. Uric acid, gout and the kidney. J. Clin. Pathol. 1981; 34: 1245—1254.
  6. Kuo C. F., See L. C., Luo S. F. et al. Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology (Oxford) 2919; 49 (1): 141—146.
  7. Krishnan E., Svendsen K., Neaton J. D. et al. Long-term cardiovascular mortality among middle-aged men with gout. Arch. Intern. Med. 2008; 168: 1104—1110.
  8. Kim S. Y., De Vera M. A., Choi H. K. Gout and mortality. Circulation 2008; 26: 115—119.
  9. Choi H. K., Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation 2007; 116: 894—900.
  10. Krishnan E., Baker J. F., Furst D. E. et al. Gout and the risk of acute myocardial infarction. Arthr. and Rheum. 2006; 54: 2688—2696.
  11. Abdullah M. Alshehri. Acute myocardial infarction associatedwith acute gouty arthritis. J. Saudi Heart Assoc. 2010; 22: 145—147.
  12. Edwards N. L. The role of hyperuricemia and gout in kidney and cardiovascular disease. Cleveland Clin. J. Med. 2008; 75: 13—16.
  13. Talbott J. H., Terplan K. L. The kidney in gout. Medicine (Baltimore) 1960; 39: 405—467.
  14. Berger L., Yu T. F. Renal function in gout. IV. An analysis of 524 gouty subjects including long-term follow-up studies. Am. J. Med. 1975; 59: 605—613.
  15. Cohen S. D., Kimmel P. L., Neff R. et al. Association of incident gout and mortality in dialysis patients. J. Am. Soc. Nephrol. 2008; 19: 2204—2210.
  16. Singer J. Z., Wallace S. L. The allopurinol hypersensitivity syndrome. Unnecessary morbidity and mortality. Arthr. and Rheum. 1986; 29: 82—87.
  17. Laurisch S., Jaedtke M., Demir R. et al. Allopurinol-induced hypersensitivity syndrome resulting in death. Med. Klin. 2010; 105 (4): 262—266.
  18. Hande K. R., Noone R. M., Stone W. J. Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency. Am. J. Med. 1984; 76: 47—56.
  19. Ventura F., Fracasso T., Leoncini A. et al. Death caused by toxic epidermal necrolysis (Loyell syndrome). J. Forens. Sci. 2010; 55 (3): 839—841.
  20. Lee M. H., Graham G. G., Williams K. M. et al. A benefit-risk assessment of benzbromarone in the treatment of gout. Was its withdrawal from the market in the best interest of patients? Drug Saf. 2008; 31: 643—665.
  21. Mullins M., Cannarozzi A. A., Bailey T. C., Ranganathan P. Unrecognized fatalities related to colchicines in hospitalized patients. Clin. Toxicol. 2011; 49 (7): 648—652.
  22. Yu K. H., Ho H. H., Chen J. Y., Luo S. F. Gout complicated with necrotizing fasciitis — report of 15 cases. Rheumatology (Oxford) 2004; 43 (4): 518—521.
  23. Wallace S. L., Robinson H., Masi A. T. et al. Preliminary criteria for the classification of the acute arthritis of gout. Arthr. and Rheum. 1977; 20: 895—900.
  24. Alberty K. G., Zimmet P. Z. For the WHO Consultation. Definition. diagnosis and classification of diabetes mellitus and its complications. Part I. Diagnosis and classification of diabetes mellitus: provisional report of a WHO consultation. Diabet. Med. 1998; 15: 539—553.
  25. Cobonian A. V., Bakris G. L., Black H. R. et al. The 7-th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. J. A. M. A. 2003; 289 (19): 2560—2571.
  26. Seidell J. Obesity in Europe. Obes. Res. 1995; 3 (Suppl. 2): 89—93.
  27. Executive Summary of the 3-rd Report of the National Cholesterol Education Program (nCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood of Cholesterol in Adults (Adult Treatment Panel III). J. A. M. A. 2001; 285 (19): 2486—2497.
  28. Bonora E., Targher G., Alberiche M. et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabet. Care 2000; 23: 57—63.
  29. Matthews D. R., Hoscer J. P., Rudenski A. S. et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412—419.
  30. Choi H. K., Hernan M. A., Seeger J. D. et al. Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 2002; 1173—1177.
  31. Matteson E. L., Gold K. N., Bloch D. A., Hunder G. G. Long-term survival of patients with giant cell arteritis in the American College of Rheumatology giant cell arteritis classification criteria cohort. Am. J. Med. 1996; 100: 193—196.
  32. Ward M. M. Premature morbidity from cardiovascular and cerebrovascular diseasres in women with systemic lupus erythematosus. Arthr. a Rheum. 1999; 42: 338—346.
  33. Amante E. J., Choi H. K. Mortality impact of common rheumatic disorders: a meta-analysis. Arthr. and Rheum. 2001; 44: 2951.
  34. Клюквина Н. Г., Насонов Е. Л. Выживаемость мужчин, страдающих системной красной волчанкой. Науч.-практ. ревматол. 2009; 6: 46—51.
  35. Kuo C. F., Yu K. H., See L. C. et al. Elevated risk of mortality among gout patients: A comparison with the National Population in Taiwan. Joint Bone Spine. 2011 Mar 7.
  36. Ungerleider H. E. The internist and life insurance. Ann. Intern. Med. 1954; 41: 124—130.
  37. Talbott J. H., Lilienfeld A. Longevity in gout. Geriatrics 1959; 14: 409—420.
  38. De Vera M. A., Rahman M. M., Bhole V. et al. Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study. Ann. Rheum. Dis. 2010; 69 (6): 1162—1164.
  39. Насонова В. А., Елисеев М. С., Барскова В. Г. Влияние возраста на частоту и выраженность признаков метаболического синдрома у больных подагрой. Соврем. ревматол. 2007; 1: 31—36.
  40. Darlington L. G., Slack J., Scott J. T. Long-term cardiovascular mortality among middle-aged men with gout. Ann. Rheum. Dis. 1983; 42: 270—273.
  41. Ogryzlo M. A. Gout its effect on morbidity and mortality. In: Proceedings of the 21-st Annual Meeting of the Canadian Life Insurance Medical Officers Association. Toronto; 1966. 71—79.
  42. Baker J. F., Krishnan E., Chen L., Schumacher H. R. Serum uric acid and cardiovascular disease: recent developments, and where do they leave us? Am. J. Med. 2005; 118: 816—826.
  43. Барскова В. Г., Ильиных Е. В., Елисеев М. С. и др. Кардиоваскулярный риск у больных подагрой. Ожирение и метаболизм 2006; 3 (8): 40—44.
  44. Eliseev M. S., Barskova V. G., Nassonova V. A., Nassonov E. L. Insulin resistance syndrome in patients with gout and its influence on uric acid concentration and severity of arthritis. Ann. Rheum. Dis. 2006; 65 (Suppl. II): 432.
  45. Hernandez-Cuevas C. B., Roque L. H. et al. First acute gout attacks commonly precede features of the metabolic syndrome. J. Clin. Rheumatol. 2009; 15 (2): 65—67.
  46. Hjortnaes J., Algra A., Olijhoek J. et al. Serum uric acid levels and risk for vascular disease in patients with metabolic syndrome. J. Rheumatol. 2007; 34: 1882—1887.
  47. Ильина А. Е., Варфоломеева Е. И., Мач Э. С. и др. Взаимосвязь между толщиной комплекса интима—медиа, факторами риска развития сердечно-сосудистых заболеваний и уровнем С-реактивного белка у пациентов с подагрой. Тер. арх. 2009; 10: 45—49.
  48. Елисеев М. С., Барскова В. Г., Насонов Е. Л. и др. Применение симвастатина у больных подагрой и гиперхолестеринемией. Лечащий врач 2009; 4: 39—43.

Copyright (c) 2012 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies