痛风患者发生心肌梗死和心力衰竭的风险：一项系统评价和荟萃分析。
Risk of myocardial infarction and heart failure in gout patients: a systematic review and meta-analysis.
作者信息
Wang Panpan, Yang Huanhuan
机构信息
Department of Endocrinology, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou, 311100, China.
Department of General Internal Medicine, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310023, China.
出版信息
J Cardiothorac Surg. 2025 Jan 17;20(1):69. doi: 10.1186/s13019-024-03209-5.
BACKGROUND
Gout is a metabolic disease caused by decreased blood uric acid excretion and purine metabolism disorders. Long-term and persistent metabolic dysfunction gradually affects other organ functions and is the main factor inducing Myocardial Infarction (MI) and Heart Failure (HF), seriously affecting the health of patients. This study adopts a meta-analysis to analyze the risk of MI and HF in gout patients.
METHODS
Clinical research literature related to gout complicated with MI or HF was searched in databases such as PubMed, Embase, Web of Science, Cochrane Library, etc. through computer retrieval before March 2023. Literature content was carefully read and retrieved, and screening was conducted based on inclusion and exclusion criteria. Relevant data were extracted from the final screened literature, and a forest map was drawn using RevMan 5.3 software for meta-analysis.
RESULTS
After searching in various databases, 2519 articles were obtained. After screening, 8 articles were finally included for meta-analysis. Among the 22 included literature, 9 analyzed the risk of gout and MI, and heterogeneity tests showed P = 0.20 and I = 28%. Fixing effects analysis showed RR = 4.60, 95%CI = 4.39-4.82, and P < 0.001. Nine articles analyzed the risk of gout and HF, and heterogeneity tests showed that P = 0.13 and I = 37%. Fixing effects analysis showed RR = 2.71, 95%CI = 2.61-2.82, and P < 0.001. Eight studies compared the incidence of MI or HF between male gout and non-gout patients. Heterogeneity tests showed P = 0.21 and I = 28%, while fixing effects analysis showed RR = 1.98 and 95%CI = 1.89-2.01, with P < 0.001. Four articles statistically compared the incidence of MI or HF between female gout and non-gout patients. Heterogeneity tests showed P = 0.15 and I = 43%. Fixing effects analysis showed RR = 1.70, 95%CI = 1.57-1.83, and P < 0.001. Thirteen studies compared the incidence of MI or HF in gout patients of different genders. Heterogeneity tests showed P = 0.37 and I = 7%. Fixing effects analysis showed RR = 0.03, 95%CI = 0.03-0.03, and P < 0.001.
CONCLUSION
Compared to non-gout patients, gout patients are more prone to MI or HF and are not affected by gender. However, among gout patients, women have a higher risk of MI or HF than men.
背景
痛风是一种由于血尿酸排泄减少和嘌呤代谢紊乱引起的代谢性疾病。长期持续的代谢功能障碍会逐渐影响其他器官功能，是诱发心肌梗死（MI）和心力衰竭（HF）的主要因素，严重影响患者健康。本研究采用荟萃分析来分析痛风患者发生MI和HF的风险。
方法
于2023年3月前通过计算机检索PubMed、Embase、Web of Science、Cochrane Library等数据库中与痛风合并MI或HF相关的临床研究文献。仔细阅读并检索文献内容，根据纳入和排除标准进行筛选。从最终筛选出的文献中提取相关数据，使用RevMan 5.3软件绘制森林图进行荟萃分析。
结果
在各个数据库中检索后，共获得2519篇文章。筛选后，最终纳入8篇文章进行荟萃分析。在纳入的22篇文献中，9篇分析了痛风与MI的风险，异质性检验显示P = 0.20，I = 28%。固定效应分析显示RR = 4.60，95%CI = 4.39 - 4.82，P < 0.001。9篇文章分析了痛风与HF的风险，异质性检验显示P = 0.13，I = 37%。固定效应分析显示RR = 2.71，95%CI = 2.61 - 2.82，P < 0.001。8项研究比较了男性痛风患者与非痛风患者MI或HF的发生率。异质性检验显示P = 0.21，I = 28%，而固定效应分析显示RR = 1.98，95%CI = 1.89 - 2.01，P < 0.001。4篇文章对女性痛风患者与非痛风患者MI或HF的发生率进行了统计学比较。异质性检验显示P = 0.15，I = 43%。固定效应分析显示RR = 1.70，95%CI = 1.57 - 1.83，P < 0.001。13项研究比较了不同性别的痛风患者MI或HF的发生率。异质性检验显示P = 0.37，I = 7%。固定效应分析显示RR = 0.03，95%CI = 0.03 - 0.03，P < 0.001。
结论
与非痛风患者相比，痛风患者更易发生MI或HF，且不受性别影响。然而，在痛风患者中，女性发生MI或HF的风险高于男性。
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