“Overall,” he concludes, “this study has provided a novel and non-invasive way of looking at the relationship between gout and cardiovascular disease and has clinical applicability, especially if the similar findings can be reproduced in the future studies.”
Aryan Aiyer, MD, director, UPMC Heart and Vascular Institute Lipid Clinic, tells Reuters Health the study “lends further credence to the well-established notion that certain systemic inflammatory conditions may increase cardiovascular risk.”
“What is unclear is if the detection of MSU deposits is a new, independent marker of risk,” he said by email. “That cannot be concluded from this study. Further studies need to be done to clarify this association and the mechanisms involved.”
“Another huge drawback of this study is the small sample size involved,” he noted. “These findings need to be replicated in a larger sample of patients.”
“DECT is not ready for prime time use in a clinical setting, as it has not been established that measuring MSU deposits can improve coronary risk prediction above current risk models,” he said.
“What clinicians may cautiously observe from this study is that the prevalence of coronary calcium was noted to be higher in the group of patients with gout,” he added. “If clinicians are unclear about coronary risk in patients with gout, quantitative coronary calcium assessment with low-dose CT could potentially be useful to individualize that patient’s coronary risk.”
Dr. Strobl did not respond to requests for a comment.
Reference
- Klauser AS, Halpern EJ, Strobl S, et al. Dual-energy computed tomography detection of cardiovascular monosodium urate deposits in patients with gout. JAMA Cardiol. 2019 Sep 11. [Epub ahead of print]
