A case-control study of determinants for the occurrence of gouty arthritis in heart failure patients

Berdine A A Hueskes, Frank F Willems, Aukelien C Leen, Patricia A Ninaber, Richard Westra, Aukje K Mantel-Teeuwisse, Hein J E M Janssens, Eloy H van de Lisdonk, Elisabeth A Roovers, Matthijs Janssen

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Abstract

AIMS: Gouty arthritis is a frequent and disabling complication in heart failure patients. This study aimed to investigate which factors are associated with the occurrence of gouty arthritis in these patients.

METHODS AND RESULTS: A case-control study was performed in heart failure patients (February 2007 to October 2009). Cases were defined as patients with gouty arthritis. Factors that are possibly associated with gouty arthritis and/or heart failure were evaluated. Echocardiographic dimensions and laboratory values including glomerular filtration rate (GFR) and fractional excretion of uric acid (FEUA) were measured. Logistic regression analysis was used to determine crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for possibly associated factors. In total, 188 patients (59 with gouty arthritis) were included. Spironolactone use was associated with a decreased occurrence of gouty arthritis (OR 0.32, 95% CI 0.13-0.77). Independently associated with an increased occurrence of gouty arthritis were hypertensive heart failure (OR 3.6, 95% CI 1.6-8.2), New York Heart Association (NYHA) class III/IV (OR 4.5, 95% CI 1.8-11.0), lower GFR (P < 0.001), and FEUA <4% (OR 3.3, 95% CI 1.4-7.9). Among the four age/gender groups, the strongest association with gouty arthritis was found in men <65 years.

CONCLUSION: Our identification of factors that are associated with the occurrence of gouty arthritis makes it possible to develop strategies to improve further the quality of life in heart failure patients. The possible decreased occurrence of gouty arthritis in spironolactone users has to be confirmed in prospective studies.

Original languageEnglish
Pages (from-to)916-921
Number of pages6
JournalEuropean Journal of Heart Failure
Volume14
Issue number8
DOIs
Publication statusPublished - Aug 2012

Keywords

  • Aged
  • Antihypertensive Agents
  • Arthritis, Gouty
  • Case-Control Studies
  • Confidence Intervals
  • Female
  • Glomerular Filtration Rate
  • Heart Failure
  • Humans
  • Kidney
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • Sodium Potassium Chloride Symporter Inhibitors
  • Spironolactone

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