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Author Notes:

Hemant Goyal, FACP, MBBS, MD, Assistant Professor, Department of Internal Medicine, Macon University School of Medicine, 707 Pine St., Macon, GA31207, United States. doc.hemant@yahoo.com

Desai R and Parekh T equal contribution to the manuscript; Desai R, Sachdeva R and Kumar G contributed to conception and design; Desai R and Doshi R contributed to provision of study material or patients; all authors contributed to collection and assembly of data, data analysis and interpretation, manuscript writing and final approval of manuscript.

The authors have no conflicts of interest to declare.



  • Acute coronary syndrome
  • Coronary artery bypass grafting
  • Gout
  • In-hospital outcomes
  • Myocardial infarction
  • Percutaneous coronary intervention
  • Revascularization
  • Serum uric acid
  • Unstable angina

Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample.


Journal Title:

World J Cardiol


Volume 11, Number 5


, Pages 137-148

Type of Work:

Article | Final Publisher PDF


BACKGROUND: Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate. AIM: To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality. METHODS: We used the national inpatient sample (2010-2014) to identify the ACS and gout-related hospitalizations, relevant comorbidities, revascularization and post-revascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality. RESULTS: We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACS-gout cohort (P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17-1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization (P < 0.001). Odds of post-revascularization in-hospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white (P < 0.001). However, post-operative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort. CONCLUSION: Although gout was not independently associated with an increased risk of post-revascularization in-hospital mortality in ACS, it did increase post-revascularization complications.

Copyright information:

©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/rdf).
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