UBC Faculty Research and Publications

Trends of Venous Thromboembolism Risk Before and After Diagnosis of Gout : A General Population-Based Study Li, Lingyi; McCormick, Natalie; Sayre, E. C; Esdaile, John M.; Lacaille, Diane; Xie, Hui; Choi, Hyon K.; Aviña-Zubieta, Juan Antonio


Objective: To estimate the overall risk and the temporal trend of VTE, DVT, and PE before and after gout diagnosis in an incident gout cohort compared with the general population. Methods: We conducted a matched cohort study using a province-wide population-based administrative health database in Canada. We calculated incidence rates (IRs) and multivariable adjusted hazard ratios (HRs) for the risk of VTE, DVT, and PE before and after gout diagnosis. Results: Among 130,708 incident individuals with gout (64% male, mean age 59 years), 2,071 developed VTE, 1,377 developed DVT and 1,012 developed PE. IRs per 1000 person-years for gout were 2.63, 1.74, and 1.28 compared with 2.03, 1.28 and 1.06 for non-gout, respectively. The fully adjusted HRs (95% CI) for VTE, DVT, and PE were 1.22 (1.13-1.32), 1.28 (1.17-1.41), and 1.16 (1.05-1.29). For the pre-gout period, the fully adjusted HRs (95% CI) were 1.51 (1.38-1.64), 1.55 (1.40-1.72) and 1.47 (1.31-1.66) for VTE, DVT, and PE. During the 3rd, 2nd, and 1st years preceding gout, the fully adjusted HRs for VTE were 1.44, 1.56, and 1.62. During the 1st, 2nd, 3rd, 4th, and 5th years after gout, the fully adjusted HRs were 1.63, 1.29, 1.33, 1.28, and 1.22. Similar trends were also seen for DVT and PE. Conclusion: Increased risks of VTE, DVT, and PE were found both before and after gout diagnosis. The risk increased gradually before gout, peaking in the year prior to diagnosis, and then progressively declined. Gout-associated inflammation may contribute to venous thrombosis risk.

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