Urate-lowering therapy in patients with hyperuricemia and heart failure: A retrospective cohort study using the UK Clinical Practice Research Datalink

Clin Cardiol. 2024 Jun;47(6):e24297. doi: 10.1002/clc.24297.

Abstract

Background: Elevated serum uric acid (sUA) is associated with heart failure (HF).

Hypothesis: Urate-lowering therapy (ULT) in HF is associated with lower risk of HF hospitalization (hHF) and mortality.

Methods: Data on patients with HF and gout or hyperuricemia in the Clinical Practice Research Datalink database linked to the Hospital Episode Statistics and the Office for National Statistics in the United Kingdom were analyzed. Risks of hHF and all-cause mortality or cardiovascular-related mortality by ULT exposure (ULT initiated within ≤6 months of gout or hyperuricemia diagnosis) were analyzed in a propensity score-matched cohort using adjusted Cox proportional hazards regression models.

Results: Of 2174 propensity score-matched pairs, patients were predominantly male, aged >70 years, with mean ± standard deviation sUA 9.3 ± 1.8 (ULT-exposed) and 9.4 ± 1.9 mg/dL (ULT-unexposed). At 5 years, ULT-exposed patients had a 43% lower risk of hHF or all-cause mortality (adjusted hazard ratio [HR]: 0.57; 95% confidence interval [CI]: 0.51-0.65) and a 19% lower risk of hHF or cardiovascular-related mortality (adjusted HR: 0.81; 95% CI: 0.71-0.92) versus no ULT exposure.

Conclusion: ULT was associated with reduced risk of adverse clinical outcomes in patients with HF and gout or hyperuricemia over 5 years.

Keywords: gout; heart failure; hyperuricemia; urate‐lowering therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Gout / blood
  • Gout / complications
  • Gout / drug therapy
  • Gout / epidemiology
  • Gout Suppressants* / therapeutic use
  • Heart Failure* / drug therapy
  • Heart Failure* / epidemiology
  • Heart Failure* / mortality
  • Humans
  • Hyperuricemia* / blood
  • Hyperuricemia* / complications
  • Hyperuricemia* / drug therapy
  • Hyperuricemia* / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • United Kingdom / epidemiology
  • Uric Acid* / blood

Substances

  • Uric Acid
  • Gout Suppressants
  • Biomarkers

Grants and funding