AFib patients with gout face greater stroke risk—but therapy can help
Gout is associated with a significantly higher risk of stroke in patients with atrial fibrillation (AFib), according to new data published in Stroke.[1]
“AFib is the most common cardiac arrhythmia, affecting up to 5.2% of the adult population,” wrote first author Antti Palomäki, MD, PhD, a researcher with Turku University Hospital in Finland and colleagues. “It is a major cause of ischemic stroke, with the risk of stroke varying considerably among individuals based on their specific comorbidities and other characteristics. With optimal therapy, including oral anticoagulant (OAC) treatment as well as management of relevant comorbidities, the risk of stroke can be significantly reduced. Identifying patients who would benefit from OAC therapy and have modifiable stroke risk factors is therefore essential for improving their prognosis.”
Gout, the group added, is a common form of inflammatory arthritis that clinicians are seeing more and more. Patients with gout often share many of the same risk factors seen in patients with AFib, including “older age, male sex, obesity, hypertension, chronic kidney disease and alcohol use.”
Palomäki et al. explored the nationwide Finnish Anticoagulation in Atrial Fibrillation study, focusing on data from nearly 230,000 patients with new-onset AFib. The mean age was 72.7 years old, and 50% of patients were men. While 3% of patients had a history of gout, 7.1% experience an ischemic stroke over the course of the study.
Overall, the authors found that AFib patients with a history of gout were much more likely to experience a stroke; this was true in both adjusted and unadjusted analyses.
In addition, using urate-lowering therapy to target a patient’s gout helped reduce their overall stroke risk. Gout is under treated, the authors added, and these data highlight yet another benefit of helping patients receive the care they need.
“Considering gout in addition to conventional risk scores could improve stroke risk stratification,” Palomäki and colleagues wrote., suggesting gout may be a “modifiable risk factor for stroke in patients with AFib.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.