Researchers aimed to address the associations between gout and ischemic events, specifically ischemic colitis.
With previous literature showing associations between gout and ischemic events, researchers confirmed that patients living with gout are more susceptible of developing ischemic events like ischemic colitis. Among individuals hospitalized with ischemic colitis, however, patients were less likely to experience sepsis, shock, intensive care unit (ICU) admission, and death.
“Gout is the most common form of inflammatory arthropathy. It occurs due to urate crystal deposition within the joint space, usually in the setting of hyperuricemia. Gout has been associated with an increased risk of ischemic events including ischemic stroke and myocardial infarction,” wrote authors of a poster presented at the American College of Rheumatology Convergence 2024.1
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Ischemic colitis is the most common type of mesenteric ischemia, meaning that blood flow to the mesentery organ of the digestive system is blocked or restricted.2 Previous literature has shown a unique relationship between the digestive system and cardiovascular health, but the direct relationship between gout and ischemic colitis has yet to be thoroughly explored.
Using 2020 Nationwide Inpatient Sample (NIS) data, researchers identified a group of hospitalized patients with gout. “Data were collected regarding incidence of shock, sepsis, peritonitis, bowel perforation, blood transfusion, ICU admission, and death. Other variables included age, gender, race, primary insurance, median income, hospital region, hospital bed size, length of stay (LOS), total hospitalization charges, and Charlson comorbidities,” continued authors of the poster.1
They then compared outcomes of hospitalized patients with both ischemic colitis and gout, aiming to identify a significant relationship between each outcome.
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There were 67,685 participants with ischemic colitis included in the study. Among this patient population, 2234 (mean age, 72.6 years; 61.2% men; 72.9% White) also had a gout diagnosis at the time of data collection.
“Patients with gout had higher odds of developing ischemic colitis compared to those without. On multivariate logistic regression analysis, presence of gout in patients with ischemic colitis was associated with a decreased risk of sepsis, shock, ICU admission, and in-hospital mortality,” wrote authors of the study.1
The researchers findings confirm previous literature regarding an association between gout and ischemic events. While patients in the study exhibited a less likely chance of experiencing sepsis, shock, ICU admission, and death, the key finding in gout and ischemic colitis’ relationship allowed researchers to identify gout specifically as a key marker for outcomes in patients with ischemic colitis.
One example of gout showing links to cardiovascular outcomes, like ischemic colitis, was highlighted in a previous article published in JAMA. Researchers aimed to address the association between gout flare ups and how likely subsequent cardiovascular events would occur in that specific patient population.
“Among individuals with gout, those who experienced a cardiovascular event, compared with those who did not experience such an event, had significantly higher odds of a recent gout flare in the preceding days,” wrote authors of the study.3
Like authors of the research poster, in the JAMA study, researchers continued to highlight the relationship between gout and cardiovascular events. However, they agreed that more research is needed to further understand the relationship between gout and ischemic events in either the cardiovascular or digestive system.
“Gout may be a marker of better outcomes in patients with ischemic colitis, bringing about the question of antioxidative effects of uric acid playing a role. Further studies are needed to explore the underlying mechanisms of our findings,” concluded authors of the poster.1
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