Abstract

Endothelial dysfunction and subclinical atheromatosis in gout: A Spanish multicenter cross-sectional study

Author(s): Enrique Calvo-Aranda, Marta Novella-Navarro, Jorge Gonzalez-Martin, Afnan AbdelkaderAbu-Sneimeh, Ofelia Carrion, Felipe Sainz & Paloma Garcia de la Pena Lefebvre

Objectives: To assess subclinical vascular features in gout patients using carotid ultrasound and flow mediated vasodilation as measures of cardiovascular risk. Methods: Cross-sectional study over a cohort of 150 patients diagnosed with gout, on whom a vascular study was performed to assess angiodynamic parameters measured by flow mediated vasodilation in brachial artery and pathological findings in carotid ultrasound: carotid intima-media thickness and atherosclerotic plaques. Classical cardiovascular risk factors were also assessed, as well as main features of gout in terms of joint involvement and inflammation parameters. Results: 150 patients with gout were recruited. 81% of patients had endothelial dysfunction, being severe in 51%. Carotid intima-media thickness was pathological in 66% and atherosclerotic plaques were present in 38%. 73% of patients had low vitamin D levels and elevation of homocysteine was present in 38% of the sample. A negative correlation between vitamin D levels and endothelial dysfunction was obtained (OR= 0.27; CI 95% 0.09-0.83). No other features related to gout (serum uric acid levels, joint involvement, inflammatory parameters or treatments) were associated to vascular damage in this cohort. Conclusions: Patients with gout have a great prevalence of subclinical vascular involvement, mainly endothelial dysfunction. So a correct characterization of vascular damage is important in these patients to better assessment and management of cardiovascular risk.