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Review
. 2015 Jul 31;10(7):e0134088.
doi: 10.1371/journal.pone.0134088. eCollection 2015.

Gout and Risk of Myocardial Infarction: A Systematic Review and Meta-Analysis of Cohort Studies

Shuang-Chun Liu  1 , Lei Xia  2 , Jin Zhang  1 , Xue-Hong Lu  3 , Da-Kang Hu  1 , Hai-Tao Zhang  4 , Hai-Jun Li  5
Affiliations
Review

Gout and Risk of Myocardial Infarction: A Systematic Review and Meta-Analysis of Cohort Studies

Shuang-Chun Liu et al. PLoS One. .

Abstract

Introduction: A high incidence of myocardial infarction among patients with gout has been suggested by several observational studies. We performed a meta-analysis to evaluate the association between gout and the risk of myocardial infarction.

Materials and methods: The PubMed and Embase databases were searched from inception to October 2014 for cohort studies that evaluating the association between gout and the risk of myocardial infarction. Summary estimates were derived using a random-effects model and reported as relative risks (RRs) with 95% confidence intervals (CIs).

Results: Five studies involving 8,656,413 participants with a total of 1000 MI events were included. Overall, gout was associated with an increased risk of myocardial infarction (RR 1.45; 95% CI, 1.19-1.75; p<0.001), and the association referred to non-fatal myocardial infarction (RR 1.29; 95% CI, 1.19-1.39; p <0.001) but not fatal myocardial infarction (RR 1.11; 95% CI, 0.96-1.28; p = 0.174). The increased risk was observed in both women (RR 1.62; 95% CI, 1.18-2.21; p = 0.003) and men (RR 1.45; 95% CI, 1.21-1.74; p <0.001). Stratified analysis revealed a gradual increase in myocardial infarction risk with a younger age of gout onset (age 20-44 years old (RR 2.82; 95% CI, 1.38-5.79; p = 0.05); 45-69 years old (RR 1.85; 95% CI, 1.22-2.82; p = 0.04); ≥70 years old (RR 1.52; 95% CI, 1.22-1.88; p <0.001)).

Conclusion: This meta-analysis suggests that patients with gout have an increased risk of myocardial infarction.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram for selection of articles.
Fig 2
Fig 2. Forest plot showing the risk of myocardial infarction in patients with gout.
Fig 3
Fig 3. Meta-analysis of the association between gout and different kinds of myocardial infarction (MI; fatal MI and non-fatal MI).
Fig 4
Fig 4. Meta-analysis of the association between gout and risk of myocardial infarction in women and men.
Fig 5
Fig 5. Meta-analysis of the association between gout and risk of myocardial infarction in age groups.
See this image and copyright information in PMC

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Grants and funding

The present study was supported by Medical Science and Technology Support of Zhejiang Province (2013ZHB015). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.