Subclinical Atherosclerosis in a Gout Cohort: Prevalence and Associations

Curr Health Sci J. 2024 Apr-Jun;50(2):274-282. doi: 10.12865/CHSJ.50.02.13. Epub 2024 Jun 30.

Abstract

The current observational, prospective study enrolled 65 patients with gout, diagnosed according to 2015 ACR/EULAR criteria [17], evaluated in Rheumatology Clinic, Emergency County Hospital Craiova, and 40 healthy subjects. This research aimed to determine the presence of subclinical carotid atherosclerosis, revealed by an increased intima media thickness and carotid plaques in gout patients, by US examination. Secondary, we aimed to search for the possible correlations displayed between the presence of subclinical carotid atherosclerosis and several disease variables. CCAIMT over 0.9mm was identified for 19 patients (29.23%), percentage statistically significant different compared to controls (7; 17.5%), p=0,0428. For 23 patients (35.38%) carotid plaques were present at US examination, more prevalent compared to controls (19; 29.23%), p=0.002. Using multivariate logistic regression, we pointed out that SUA (OR 2,103; p=0.0002), age (OR=1,051; p<0.001), disease duration (OR=1.740; p=0.0039) and LDLc (OR=1,003; p=0.0029) were independently associated to an increased IMT in patients with gout, similar results being obtained for carotid plaques. MSKUS was performed for all patients, with important results. The presence of deposits associated with an increased risk of a thick IMT; similar results were obtained for double contour sign, aggregates and tophi. A statistically significant risk was noticed for the presence of deposits (p=0.002). Regarding the presence of carotid atheroma plaques, a higher risk was associated to deposits identification, double contour sign, aggregates, tophi and PD signal. Our results sustain that carotid ultrasound is an easily accessible imagistic method that offers important predictors of atherosclerotic status.

Keywords: Gout; carotid ultrasound; subclinical atherosclerosis.