Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample

BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome(ACS)-related hospitalizations and post-revascularization is inadequate.AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations,subsequent healthcare burden and predictors of post-revascularization inpatient mortality.METHODS We used the national inpatient sample(2010-2014) to identify the ACS and goutrelated hospitalizations, relevant comorbidities, revascularization and postrevascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality.RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198(3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac(3.2% vs 2.9%), respiratory(3.5% vs 2.9%), and hemorrhage(3.1% vs 2.7%)were higher whereas all-cause mortality was lower(2.2% vs 3.0%) in the ACSgout cohort(P 0.001). An older age(OR 15.63, CI: 5.51-44.39), non-elective admissions(OR 2.00, CI: 1.44-2.79), lower household income(OR 1.44, CI: 1.17-1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization(P 0.001). Odds of post-revascularization inhospital mortality were lower in Hispanics(OR 0.45, CI: 0.31-0.67) and Asians(OR 0.65, CI: 0.45-0.94) as compared to white(P 0.001). However, postoperative complications significantly raised mortality odds. Mean length of stay,transfer to other facilities, and hospital charges were higher in the ACS-gout cohort.CONCLUSION Although gout was not independently associated with an increased risk of postrevascularization in-hospital mortality in ACS, it did increase postrevascularization complications.     

Risk of Colchicine-Associated Myopathy in Gout: Influence of Concomitant Use of Statin

Objective

The purpose of this study was to investigate the risk of myopathy when statins are coadministered with colchicine in patients with gout.

痛风中医证候与并发症相关因素的研究

目的探寻痛风常见辨证分型的理化因素的变化规律。方法对150例痛风患者进行辨证分型,统计其实验室检查指标,分析相关因素。结果湿热蕴结证、瘀热阻滞证、痰瘀阻滞证、肝肾阴虚证4种证型血尿酸、血糖、血脂、均高于正常值,ESR、CRP值均略高于正常值,各证型间水平相近。结论痛风与实验室指标密切相关;在其发病过程中,常伴随代谢综合征的发生。     

脂联素及高敏C反应蛋白与原发性高血压合并痛风的关系

目的:探讨高血压合并痛风患者治疗前后血清脂联素(APN)、高敏C反应蛋白(hs-CRP)水平的变化并分析其之间的关系。方法:选择桂林医学院附属医院心内科门诊和住院患者120例,分为高血压合并痛风组60例、高血压组30例、痛风组30例3组。对照组30例为同期我院体检中心健康体检者。采用酶联免疫吸附法(ELISA)测定血清APN,免疫散射比浊法测定血清hs-CRP。结果:高血压合并痛风患者治疗后较治疗前APN升高,hs-CRP降低;高血压合并痛风组APN与hs-CRP呈负相关。结论:高血压合并痛风患者随血压及尿酸水平较低,血清APN升高,炎症标志物hs-CRP降低。     

痛风的诊断与治疗

正常情况下,人体每天尿酸的产生和排泄基本上保持动态平衡,凡是影响血尿酸生成和(或)排泄的因素均可以导致血尿酸水平增加.约有5％～12％的高尿酸血症患者最终会发展成为痛风.痛风的诊断标准有罗马标准、纽约标准、美国风湿病学会(ACR)标准、欧洲抗风湿病联盟(EULAR)关于痛风的诊断建议.痛风急性发作期的治疗包括卧床休息、...     

马宝东教授治疗痛风经验

痛风是临床常见病、多发病,发病率逐年升高,发病人群逐渐年轻化。可以导致痛风性肾损害等多种并发症。马宝东教授发挥中医整体观念、辨证论治的特色,运用中医药疗法,在痛风疾病的治疗中取得较好的临床疗效。     

上中下痛风要方联合西药治疗痛风性肾病对照临床观察

[目的]观察上中下痛风要方治疗痛风性肾病的临床疗效。[方法]将60例患者随机分为两组,对照组30例在常规治疗基础上予以促尿酸排泄药痛风利仙,或联合应用尿酸合成抑制剂别嘌醇;治疗组30例在对照组的治疗基础上同时应用上中下痛风要方治疗。两组均以4周为1个疗程,治疗2个疗程后进行疗效判定。[结果]两组在治疗8周后,血尿酸值均较治疗前有明显下降,中药治疗组较对照组有明显下降,中药治疗组24h尿蛋白定量、血尿素氮、血肌酐值较对照组及治疗前有明显下降。治疗组总有效率83.30%,对照组总有效率63.30%,总有效率治疗组优于对照组。[结论]上中下痛风要方治疗痛风性肾病疗效确切。     

中医治疗痛风临床研究

痛风又称高尿酸血症。祖国医学亦有痛风之病名,相当于痹症,历节,脚气。是嘌呤物质代谢紊乱导致血尿酸浓度增高而引起组织损伤的一种疾病。