老年女性中痛风对急性心肌梗死风险的独立影响：一项基于人群的研究。
Independent impact of gout on the risk of acute myocardial infarction among elderly women: a population-based study.
机构信息
Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada.
出版信息
Ann Rheum Dis. 2010 Jun;69(6):1162-4. doi: 10.1136/ard.2009.122770. Epub 2010 Feb 2.
BACKGROUND
Men with gout have been found to have an increased risk of acute myocardial infarction (AMI), but no corresponding data are available among women.
OBJECTIVE
To evaluate the potential independent association between gout and the risk of AMI among elderly women, aged > or = 65 years.
METHODS
A population-based cohort study was conducted using the British Columbia Linked Health Database and compared incidence rates of AMI between 9642 gout patients and 48 210 controls, with no history of ischaemic heart disease. Cox proportional hazards models stratified by gender were used to estimate the relative risk (RR) for AMI, adjusting for age, comorbidities and prescription drug use.
RESULTS
Over a 7-year median follow-up, 3268 incident AMI cases, were identified, 996 among women. Compared with women without gout, the multivariate RRs among women with gout were 1.39 (95% CI 1.20 to 1.61) for all AMI and 1.41 (95% CI 1.19 to 1.67) for non-fatal AMI. These RRs were significantly larger than those among men (multivariate RRs for all AMI and non-fatal AMI, 1.11 and 1.11; p values for interaction, 0.003 and 0.005, respectively).
CONCLUSION
These population-based data suggest that women with gout have an increased risk for AMI and the magnitude of excess risk is higher than in men.
背景
已有研究发现痛风患者发生急性心肌梗死（AMI）的风险增加，但女性痛风患者与 AMI 相关性的数据尚缺乏。
目的
评估老年女性（年龄≥65 岁）痛风与 AMI 风险之间潜在的独立相关性。
方法
采用不列颠哥伦比亚省关联健康数据库进行了一项基于人群的队列研究，比较了 9642 例痛风患者和 48210 例无缺血性心脏病史对照者的 AMI 发生率。采用 Cox 比例风险模型，按性别分层，校正年龄、合并症和处方药使用情况，估计 AMI 的相对风险（RR）。
结果
在中位 7 年随访期间，共确定了 3268 例 AMI 事件，其中 996 例发生在女性中。与无痛风的女性相比，有痛风的女性发生所有 AMI 的多变量 RR 为 1.39（95%CI 1.20 至 1.61），非致死性 AMI 的 RR 为 1.41（95%CI 1.19 至 1.67）。这些 RR 明显大于男性（所有 AMI 和非致死性 AMI 的多变量 RR 分别为 1.11 和 1.11；交互作用 p 值分别为 0.003 和 0.005）。
结论
这些基于人群的数据表明，女性痛风患者发生 AMI 的风险增加，且超额风险的幅度高于男性。
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