Skip to main content
Erschienen in: Current Rheumatology Reports 2/2010

01.04.2010

Gout, Hyperuricemia, and the Risk of Cardiovascular Disease: Cause and Effect?

verfasst von: Ankoor Shah, Robert T. Keenan

Erschienen in: Current Rheumatology Reports | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Gout and hyperuricemia have long been suspected to be risk factors for cardiovascular disease. However, studies have frequently failed to distinguish whether these entities have an independent effect on cardiovascular risk or serve as markers for other risk factors. In vitro and animal studies suggest that uric acid is a biologically active compound that can increase inflammatory mediators known to lead to vascular damage. In contrast, uric acid also has potentially protective effects as a strong antioxidant, approaching the potency of vitamin C. Large clinical trials demonstrate a consistent relationship between elevated serum uric acid and a variety of cardiovascular diseases, although the strength of association varies greatly. We review the evidence for and against an independent role for hyperuricemia and/or gout in cardiovascular pathology.
Literatur
1.
Zurück zum Zitat Watanabe S, Kang DH, Feng L, et al.: Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension 2002, 40:355–360.CrossRefPubMed Watanabe S, Kang DH, Feng L, et al.: Uric acid, hominoid evolution, and the pathogenesis of salt-sensitivity. Hypertension 2002, 40:355–360.CrossRefPubMed
2.
Zurück zum Zitat So A: Developments in the scientific and clinical understanding of gout. Arthritis Res Ther 2008, 10:221.CrossRefPubMed So A: Developments in the scientific and clinical understanding of gout. Arthritis Res Ther 2008, 10:221.CrossRefPubMed
3.
Zurück zum Zitat Hahn BH, McMahon M: Atherosclerosis and systemic lupus erythematosus: the role of altered lipids and of autoantibodies. Lupus 2008, 17:368–370.CrossRefPubMed Hahn BH, McMahon M: Atherosclerosis and systemic lupus erythematosus: the role of altered lipids and of autoantibodies. Lupus 2008, 17:368–370.CrossRefPubMed
4.
Zurück zum Zitat • Hahn BH, Grossman J, Chen W, McMahon M: The pathogenesis of atherosclerosis in autoimmune rheumatic diseases: roles of inflammation and dyslipidemia. J Autoimmun 2007, 28:69–75. This is a good review on how autoimmune rheumatic diseases play a role in accelerated or premature atherosclerosis. • Hahn BH, Grossman J, Chen W, McMahon M: The pathogenesis of atherosclerosis in autoimmune rheumatic diseases: roles of inflammation and dyslipidemia. J Autoimmun 2007, 28:69–75. This is a good review on how autoimmune rheumatic diseases play a role in accelerated or premature atherosclerosis.
5.
Zurück zum Zitat Scott P, Ma H, Viriyakosol S, et al.: Engagement of CD14 mediates the inflammatory potential of monosodium urate crystals. J Immunol 2006, 177:6370–6378.PubMed Scott P, Ma H, Viriyakosol S, et al.: Engagement of CD14 mediates the inflammatory potential of monosodium urate crystals. J Immunol 2006, 177:6370–6378.PubMed
6.
Zurück zum Zitat di Giovine FS, Malawista SE, Thornton E, Duff GW: Urate crystals stimulate production of tumor necrosis factor alpha from human blood monocytes and synovial cells. Cytokine mRNA and protein kinetics, and cellular distribution. J Clin Invest 1991, 87:1375–1381.CrossRefPubMed di Giovine FS, Malawista SE, Thornton E, Duff GW: Urate crystals stimulate production of tumor necrosis factor alpha from human blood monocytes and synovial cells. Cytokine mRNA and protein kinetics, and cellular distribution. J Clin Invest 1991, 87:1375–1381.CrossRefPubMed
7.
Zurück zum Zitat Kanellis J, Watanabe S, Li JH, et al.: Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003, 41:1287–1293.CrossRefPubMed Kanellis J, Watanabe S, Li JH, et al.: Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003, 41:1287–1293.CrossRefPubMed
8.
Zurück zum Zitat Rao GN, Corson MA, Berk BC: Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem 1991, 266:8604–8608.PubMed Rao GN, Corson MA, Berk BC: Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem 1991, 266:8604–8608.PubMed
9.
Zurück zum Zitat Corry DB, Eslami P, Yamamoto K, et al.: Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens 2008, 26:269–275.CrossRefPubMed Corry DB, Eslami P, Yamamoto K, et al.: Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin system. J Hypertens 2008, 26:269–275.CrossRefPubMed
10.
Zurück zum Zitat Sharma R, Coats AJ, Anker SD: The role of inflammatory mediators in chronic heart failure: cytokines, nitric oxide, and endothelin-1. Int J Cardiol 2000, 72:175–186.CrossRefPubMed Sharma R, Coats AJ, Anker SD: The role of inflammatory mediators in chronic heart failure: cytokines, nitric oxide, and endothelin-1. Int J Cardiol 2000, 72:175–186.CrossRefPubMed
11.
Zurück zum Zitat Chao HH, Liu JC, Lin JW, et al.: Uric acid stimulates endothelin-1 gene expression associated with NADPH oxidase in human aortic smooth muscle cells. Acta Pharmacol Sin 2008, 29:1301–1312.CrossRefPubMed Chao HH, Liu JC, Lin JW, et al.: Uric acid stimulates endothelin-1 gene expression associated with NADPH oxidase in human aortic smooth muscle cells. Acta Pharmacol Sin 2008, 29:1301–1312.CrossRefPubMed
12.
Zurück zum Zitat Cheng TH, Lin JW, Chao HH, et al.: Uric acid activates extracellular signal-regulated kinases and thereafter endothelin-1 expression in rat cardiac fibroblasts. Int J Cardiol 2008 Oct 20 (Epub ahead of print). Cheng TH, Lin JW, Chao HH, et al.: Uric acid activates extracellular signal-regulated kinases and thereafter endothelin-1 expression in rat cardiac fibroblasts. Int J Cardiol 2008 Oct 20 (Epub ahead of print).
13.
Zurück zum Zitat Ruetten H, Thiemermann C: Endothelin-1 stimulates the biosynthesis of tumour necrosis factor in macrophages: ET-receptors, signal transduction and inhibition by dexamethasone. J Physiol Pharmacol 1997, 48:675–688.PubMed Ruetten H, Thiemermann C: Endothelin-1 stimulates the biosynthesis of tumour necrosis factor in macrophages: ET-receptors, signal transduction and inhibition by dexamethasone. J Physiol Pharmacol 1997, 48:675–688.PubMed
14.
Zurück zum Zitat Suvorava T, Kojda G: Reactive oxygen species as cardiovascular mediators: lessons from endothelial-specific protein overexpression mouse models. Biochim Biophys Acta 2009, 1787:802–810.CrossRefPubMed Suvorava T, Kojda G: Reactive oxygen species as cardiovascular mediators: lessons from endothelial-specific protein overexpression mouse models. Biochim Biophys Acta 2009, 1787:802–810.CrossRefPubMed
15.
Zurück zum Zitat Madesh M, Hawkins BJ, Milovanova T, et al.: Selective role for superoxide in InsP3 receptor-mediated mitochondrial dysfunction and endothelial apoptosis. J Cell Biol 2005, 170:1079–1090.CrossRefPubMed Madesh M, Hawkins BJ, Milovanova T, et al.: Selective role for superoxide in InsP3 receptor-mediated mitochondrial dysfunction and endothelial apoptosis. J Cell Biol 2005, 170:1079–1090.CrossRefPubMed
16.
Zurück zum Zitat Papaharalambus CA, Griendling KK: Basic mechanisms of oxidative stress and reactive oxygen species in cardiovascular injury. Trends Cardiovasc Med 2007, 17:48–54.CrossRefPubMed Papaharalambus CA, Griendling KK: Basic mechanisms of oxidative stress and reactive oxygen species in cardiovascular injury. Trends Cardiovasc Med 2007, 17:48–54.CrossRefPubMed
17.
Zurück zum Zitat de Winther MP, Kanters E, Kraal G, Hofker MH: Nuclear factor kappaB signaling in atherogenesis. Arterioscler Thromb Vasc Biol 2005, 25:904–914.CrossRefPubMed de Winther MP, Kanters E, Kraal G, Hofker MH: Nuclear factor kappaB signaling in atherogenesis. Arterioscler Thromb Vasc Biol 2005, 25:904–914.CrossRefPubMed
18.
Zurück zum Zitat Martinez-Hervas S, Real JT, Ivorra C, et al.: Increased plasma xanthine oxidase activity is related to nuclear factor kappa beta activation and inflammatory markers in familial combined hyperlipidemia. Nutr Metab Cardiovasc Dis 2009 Sep 16 (Epub ahead of print). Martinez-Hervas S, Real JT, Ivorra C, et al.: Increased plasma xanthine oxidase activity is related to nuclear factor kappa beta activation and inflammatory markers in familial combined hyperlipidemia. Nutr Metab Cardiovasc Dis 2009 Sep 16 (Epub ahead of print).
19.
Zurück zum Zitat Spiekermann S, Landmesser U, Dikalov S, et al.: Electron spin resonance characterization of vascular xanthine and NAD(P)H oxidase activity in patients with coronary artery disease: relation to endothelium-dependent vasodilation. Circulation 2003, 107:1383–1389.CrossRefPubMed Spiekermann S, Landmesser U, Dikalov S, et al.: Electron spin resonance characterization of vascular xanthine and NAD(P)H oxidase activity in patients with coronary artery disease: relation to endothelium-dependent vasodilation. Circulation 2003, 107:1383–1389.CrossRefPubMed
20.
Zurück zum Zitat Baldus S, Koster R, Chumley P, et al.: Oxypurinol improves coronary and peripheral endothelial function in patients with coronary artery disease. Free Radic Biol Med 2005, 39:1184–1190.CrossRefPubMed Baldus S, Koster R, Chumley P, et al.: Oxypurinol improves coronary and peripheral endothelial function in patients with coronary artery disease. Free Radic Biol Med 2005, 39:1184–1190.CrossRefPubMed
21.
Zurück zum Zitat Berry CE, Hare JM: Xanthine oxidoreductase and cardiovascular disease: molecular mechanisms and pathophysiological implications. J Physiol 2004, 555:589–606.CrossRefPubMed Berry CE, Hare JM: Xanthine oxidoreductase and cardiovascular disease: molecular mechanisms and pathophysiological implications. J Physiol 2004, 555:589–606.CrossRefPubMed
22.
Zurück zum Zitat Kang DH, Park SK, Lee IK, Johnson RJ: Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005, 16:3553–3562.CrossRefPubMed Kang DH, Park SK, Lee IK, Johnson RJ: Uric acid-induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005, 16:3553–3562.CrossRefPubMed
23.
Zurück zum Zitat Saavedra WF, Paolocci N, St John ME, et al.: Imbalance between xanthine oxidase and nitric oxide synthase signaling pathways underlies mechanoenergetic uncoupling in the failing heart. Circ Res 2002, 90:297–304.CrossRefPubMed Saavedra WF, Paolocci N, St John ME, et al.: Imbalance between xanthine oxidase and nitric oxide synthase signaling pathways underlies mechanoenergetic uncoupling in the failing heart. Circ Res 2002, 90:297–304.CrossRefPubMed
24.
Zurück zum Zitat Zweier JL, Broderick R, Kuppusamy P, et al.: Determination of the mechanism of free radical generation in human aortic endothelial cells exposed to anoxia and reoxygenation. J Biol Chem 1994, 269:24156–24162.PubMed Zweier JL, Broderick R, Kuppusamy P, et al.: Determination of the mechanism of free radical generation in human aortic endothelial cells exposed to anoxia and reoxygenation. J Biol Chem 1994, 269:24156–24162.PubMed
25.
Zurück zum Zitat Terada LS, Rubinstein JD, Lesnefsky EJ, et al.: Existence and participation of xanthine oxidase in reperfusion injury of ischemic rabbit myocardium. Am J Physiol 1991, 260:H805–H810.PubMed Terada LS, Rubinstein JD, Lesnefsky EJ, et al.: Existence and participation of xanthine oxidase in reperfusion injury of ischemic rabbit myocardium. Am J Physiol 1991, 260:H805–H810.PubMed
26.
Zurück zum Zitat Nielsen VG, Weinbroum A, Tan S, et al.: Xanthine oxidoreductase release after descending thoracic aorta occlusion and reperfusion in rabbits. J Thorac Cardiovasc Surg 1994, 107:1222–1227.PubMed Nielsen VG, Weinbroum A, Tan S, et al.: Xanthine oxidoreductase release after descending thoracic aorta occlusion and reperfusion in rabbits. J Thorac Cardiovasc Surg 1994, 107:1222–1227.PubMed
27.
Zurück zum Zitat Guan W, Osanai T, Kamada T, et al.: Effect of allopurinol pretreatment on free radical generation after primary coronary angioplasty for acute myocardial infarction. J Cardiovasc Pharmacol 2003, 41:699–705.CrossRefPubMed Guan W, Osanai T, Kamada T, et al.: Effect of allopurinol pretreatment on free radical generation after primary coronary angioplasty for acute myocardial infarction. J Cardiovasc Pharmacol 2003, 41:699–705.CrossRefPubMed
28.
Zurück zum Zitat Ames BN, Cathcart R, Schwiers E, Hochstein P: Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci U S A 1981, 78:6858–6862.CrossRefPubMed Ames BN, Cathcart R, Schwiers E, Hochstein P: Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis. Proc Natl Acad Sci U S A 1981, 78:6858–6862.CrossRefPubMed
29.
Zurück zum Zitat Gagliardi AC, Miname MH, Santos RD: Uric acid: a marker of increased cardiovascular risk. Atherosclerosis 2009, 202:11–17.CrossRefPubMed Gagliardi AC, Miname MH, Santos RD: Uric acid: a marker of increased cardiovascular risk. Atherosclerosis 2009, 202:11–17.CrossRefPubMed
30.
Zurück zum Zitat Johnson RJ, Kang DH, Feig D, et al.: Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003, 41:1183–1190.CrossRefPubMed Johnson RJ, Kang DH, Feig D, et al.: Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003, 41:1183–1190.CrossRefPubMed
31.
Zurück zum Zitat Wheeler JG, Juzwishin KD, Eiriksdottir G, et al.: Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis. PLoS Med 2005, 2:e76.CrossRefPubMed Wheeler JG, Juzwishin KD, Eiriksdottir G, et al.: Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: prospective study and meta-analysis. PLoS Med 2005, 2:e76.CrossRefPubMed
32.
Zurück zum Zitat Keenan RT, Pillinger MH: Hyperuricemia, gout, and cardiovascular disease—an important “muddle.” Bull NYU Hosp Jt Dis 2009, 67:285–290.PubMed Keenan RT, Pillinger MH: Hyperuricemia, gout, and cardiovascular disease—an important “muddle.” Bull NYU Hosp Jt Dis 2009, 67:285–290.PubMed
33.
Zurück zum Zitat Abbott RD, Brand FN, Kannel WB, Castelli WP: Gout and coronary heart disease: the Framingham Study. J Clin Epidemiol 1988, 41:237–242.CrossRefPubMed Abbott RD, Brand FN, Kannel WB, Castelli WP: Gout and coronary heart disease: the Framingham Study. J Clin Epidemiol 1988, 41:237–242.CrossRefPubMed
34.
Zurück zum Zitat Brand FN, McGee DL, Kannel WB, et al.: Hyperuricemia as a risk factor of coronary heart disease: the Framingham Study. Am J Epidemiol 1985, 121:11–18.PubMed Brand FN, McGee DL, Kannel WB, et al.: Hyperuricemia as a risk factor of coronary heart disease: the Framingham Study. Am J Epidemiol 1985, 121:11–18.PubMed
35.
Zurück zum Zitat Niskanen LK, Laaksonen DE, Nyyssonen K, et al.: Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 2004, 164:1546–1551.CrossRefPubMed Niskanen LK, Laaksonen DE, Nyyssonen K, et al.: Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med 2004, 164:1546–1551.CrossRefPubMed
36.
Zurück zum Zitat Hoieggen A, Alderman MH, Kjeldsen SE, et al.: The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int 2004, 65:1041–1049.CrossRefPubMed Hoieggen A, Alderman MH, Kjeldsen SE, et al.: The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney Int 2004, 65:1041–1049.CrossRefPubMed
37.
Zurück zum Zitat Strazzullo P, Puig JG: Uric acid and oxidative stress: relative impact on cardiovascular risk? Nutr Metab Cardiovasc Dis 2007, 17:409–414.CrossRefPubMed Strazzullo P, Puig JG: Uric acid and oxidative stress: relative impact on cardiovascular risk? Nutr Metab Cardiovasc Dis 2007, 17:409–414.CrossRefPubMed
38.
Zurück zum Zitat Ioachimescu AG, Brennan DM, Hoar BM, et al.: Serum uric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease: a preventive cardiology information system (PreCIS) database cohort study. Arthritis Rheum 2008, 58:623–630.CrossRefPubMed Ioachimescu AG, Brennan DM, Hoar BM, et al.: Serum uric acid is an independent predictor of all-cause mortality in patients at high risk of cardiovascular disease: a preventive cardiology information system (PreCIS) database cohort study. Arthritis Rheum 2008, 58:623–630.CrossRefPubMed
39.
Zurück zum Zitat Wannamethee SG, Shaper AG, Whincup PH: Serum urate and the risk of major coronary heart disease events. Heart 1997, 78:147–153.PubMed Wannamethee SG, Shaper AG, Whincup PH: Serum urate and the risk of major coronary heart disease events. Heart 1997, 78:147–153.PubMed
40.
Zurück zum Zitat Okura T, Higaki J, Kurata M, et al.: Elevated serum uric acid is an independent predictor for cardiovascular events in patients with severe coronary artery stenosis: subanalysis of the Japanese Coronary Artery Disease (JCAD) Study. Circ J 2009, 73:885–891.CrossRefPubMed Okura T, Higaki J, Kurata M, et al.: Elevated serum uric acid is an independent predictor for cardiovascular events in patients with severe coronary artery stenosis: subanalysis of the Japanese Coronary Artery Disease (JCAD) Study. Circ J 2009, 73:885–891.CrossRefPubMed
41.
Zurück zum Zitat Madsen TE, Muhlestein JB, Carlquist JF, et al.: Serum uric acid independently predicts mortality in patients with significant, angiographically defined coronary disease. Am J Nephrol 2005, 25:45–49.CrossRefPubMed Madsen TE, Muhlestein JB, Carlquist JF, et al.: Serum uric acid independently predicts mortality in patients with significant, angiographically defined coronary disease. Am J Nephrol 2005, 25:45–49.CrossRefPubMed
42.
Zurück zum Zitat Chen JH, Chuang SY, Chen HJ, et al.: Serum uric acid level as an independent risk factor for all-cause, cardiovascular, and ischemic stroke mortality: a Chinese cohort study. Arthritis Rheum 2009, 61:225–232.CrossRefPubMed Chen JH, Chuang SY, Chen HJ, et al.: Serum uric acid level as an independent risk factor for all-cause, cardiovascular, and ischemic stroke mortality: a Chinese cohort study. Arthritis Rheum 2009, 61:225–232.CrossRefPubMed
43.
Zurück zum Zitat • Kuo CF, See LC, Luo SF, et al.: Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology (Oxford) 2010, 49:141–146. This is one of the most recent and largest population-based studies evaluating the association between hyperuricemia and CVD. • Kuo CF, See LC, Luo SF, et al.: Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology (Oxford) 2010, 49:141–146. This is one of the most recent and largest population-based studies evaluating the association between hyperuricemia and CVD.
44.
Zurück zum Zitat Stamler J, Wentworth D, Neaton JD: Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA 1986, 256:2823–2828.CrossRefPubMed Stamler J, Wentworth D, Neaton JD: Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA 1986, 256:2823–2828.CrossRefPubMed
45.
Zurück zum Zitat Krishnan E, Baker JF, Furst DE, Schumacher HR: Gout and the risk of acute myocardial infarction. Arthritis Rheum 2006, 54:2688–2696.CrossRefPubMed Krishnan E, Baker JF, Furst DE, Schumacher HR: Gout and the risk of acute myocardial infarction. Arthritis Rheum 2006, 54:2688–2696.CrossRefPubMed
46.
Zurück zum Zitat Krishnan E, Svendsen K, Neaton JD, et al.: Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med 2008, 168:1104–1110.CrossRefPubMed Krishnan E, Svendsen K, Neaton JD, et al.: Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med 2008, 168:1104–1110.CrossRefPubMed
47.
Zurück zum Zitat Sica DA, Weber M: The Losartan Intervention for Endpoint Reduction (LIFE) trial—have angiotensin-receptor blockers come of age? J Clin Hypertens (Greenwich) 2002, 4:301–305.CrossRef Sica DA, Weber M: The Losartan Intervention for Endpoint Reduction (LIFE) trial—have angiotensin-receptor blockers come of age? J Clin Hypertens (Greenwich) 2002, 4:301–305.CrossRef
48.
Zurück zum Zitat Tsioufis C, Chatzis D, Vezali E, et al.: The controversial role of serum uric acid in essential hypertension: relationships with indices of target organ damage. J Hum Hypertens 2005, 19:211–217.PubMed Tsioufis C, Chatzis D, Vezali E, et al.: The controversial role of serum uric acid in essential hypertension: relationships with indices of target organ damage. J Hum Hypertens 2005, 19:211–217.PubMed
49.
Zurück zum Zitat Doehner W, Schoene N, Rauchhaus M, et al.: Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure: results from 2 placebo-controlled studies. Circulation 2002, 105:2619–2624.CrossRefPubMed Doehner W, Schoene N, Rauchhaus M, et al.: Effects of xanthine oxidase inhibition with allopurinol on endothelial function and peripheral blood flow in hyperuricemic patients with chronic heart failure: results from 2 placebo-controlled studies. Circulation 2002, 105:2619–2624.CrossRefPubMed
50.
Zurück zum Zitat Hare JM, Mangal B, Brown J, et al.: Impact of oxypurinol in patients with symptomatic heart failure. Results of the OPT-CHF study. J Am Coll Cardiol 2008, 51:2301–2309.CrossRefPubMed Hare JM, Mangal B, Brown J, et al.: Impact of oxypurinol in patients with symptomatic heart failure. Results of the OPT-CHF study. J Am Coll Cardiol 2008, 51:2301–2309.CrossRefPubMed
51.
Zurück zum Zitat Kim SY, Guevara JP, Kim KM, et al.: Hyperuricemia and risk of stroke: a systematic review and meta-analysis. Arthritis Rheum 2009, 61:885–892.CrossRefPubMed Kim SY, Guevara JP, Kim KM, et al.: Hyperuricemia and risk of stroke: a systematic review and meta-analysis. Arthritis Rheum 2009, 61:885–892.CrossRefPubMed
52.
Zurück zum Zitat Lehto S, Niskanen L, Ronnemaa T, Laakso M: Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke 1998, 29:635–639.PubMed Lehto S, Niskanen L, Ronnemaa T, Laakso M: Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke 1998, 29:635–639.PubMed
53.
Zurück zum Zitat Weir CJ, Muir SW, Walters MR, Lees KR: Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke 2003, 34:1951–1956.CrossRefPubMed Weir CJ, Muir SW, Walters MR, Lees KR: Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke 2003, 34:1951–1956.CrossRefPubMed
54.
Zurück zum Zitat Wong KY, MacWalter RS, Fraser HW, et al.: Urate predicts subsequent cardiac death in stroke survivors. Eur Heart J 2002, 23:788–793.CrossRefPubMed Wong KY, MacWalter RS, Fraser HW, et al.: Urate predicts subsequent cardiac death in stroke survivors. Eur Heart J 2002, 23:788–793.CrossRefPubMed
Metadaten
Titel
Gout, Hyperuricemia, and the Risk of Cardiovascular Disease: Cause and Effect?
verfasst von
Ankoor Shah
Robert T. Keenan
Publikationsdatum
01.04.2010
Verlag
Current Science Inc.
Erschienen in
Current Rheumatology Reports / Ausgabe 2/2010
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-010-0084-3

Weitere Artikel der Ausgabe 2/2010

Current Rheumatology Reports 2/2010 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.