THU0597 ULTRASOUND REVEALS SUB-CLINICAL ATHEROSCLEROSIS IN PATIENTS WITH GOUT AND ASYMPTOMATIC HYPERURICEMIA

Background: Accelerated atherosclerosis and the higher risk of developing premature cardiovascular disease are well known in chronic inflammatory rheumatic diseases. Moreover, strong evidence supporting both proatherogenic and protrombotic characteristics of high levels of uric acid have been published. Ultrasound (US) measurement of the carotid intima-media thickness (cIMT) is a non-invasive outcome measure of premature sub-clinical atherosclerosis with a predictive value in terms of vascular events. Objectives: To determine the prevalence of increased cIMT, as sign of pre-clinical atherosclerosis, in patients with gout and asymptomatic hyperuricemia by an automated ultrasound (US) method. Methods: 342 subjects (138 with gout, 105 with asymptomatic hyperuricemia and 99 healthy control subjects) were enrolled. Before the US assessment, all patients underwent a clinical examination aimed to record age, gender, disease duration, smoking, ischemic cardiopathy, comorbidities (including diabetes mellitus, high blood pressure, dyslipidemia, renal insufficiency, obesity), and current therapy. Moreover, ESR, CRP, total cholesterol, HDL-high-density lipoprotein, triglycerides, fasting serum glucose, serum creatinine and uricemia were recorded. Patients with history of myocardial infarction, cerebrovascular events or autoimmune diseases were excluded. US examinations of the IMT at both common carotids were performed by a rheumatologist expert in US, using a linear probe and an automatic method (QIMT) based on the radio-frequency technology. For the IMT, a cut-off point of 0.8 mm was adopted, according Mannheim cIMT Consensus. Results: A total of 684 common carotids were assessed. In 65 (47.10%) out of the 138 patients with gout and 50 (47.62%) out of the 105 patients with asymptomatic hyperuricemia, US detected an increased cIMT and only 9 (0.09%) of the control group patients had an increased cIMT (p=0.0001). The regression analysis found a significant positive correlation between increased cIMT and disease duration in gout group (p=0.001) and between the level of uric acid and increased cIMT in asymptomatic hyperuricemic patients (p=0.009). No significant correlation was found with the other clinical and laboratory parameters. There was a significant difference in cIMT between in gout and control groups (p=0.0001) and between asymptomatic hyperuricemia and control group (p=0.0001). Conclusion: Our results demonstrate that patients with gout and hyperuricemia without clinically evident cardiovascular disease have a high prevalence of atherosclerosis represented by the increased cIMT. Disclosure of Interests: None declared