Urate in Atherosclerotic Plaques Boosts Risk for CV Events


  • Traditional risk factors do not explain the higher risk for CV events in patients with gout and hyperuricemia; therefore, understanding the association between MSU deposits, frequently present in these conditions, and MACE may help identify patients at higher risk.
  • This retrospective cohort study included 189 patients (median age, 68 years) for a median follow-up time of 33 months: 131 with gout, 40 with hyperuricemia, and 18 control individuals who underwent dual-energy CT (DECT) of the affected limb and thorax.
  • DECT scans and coronary calcium scores were used to identify MSU deposits in CV plaques.


  • Overall, 85 patients (45%) exhibited CV MSU deposits, including 62 patients with gout, 22 with hyperuricemia, and one control individual.
  • Patients with CV MSU deposits had significantly higher cardiac disease marker levels, including C-reactive protein levels (median, 17.1 vs 5.6 mg/L; = .007), uric acid levels (mean, 7.4 vs 6.4 mg/dL; = .007), and calcium scores (median, 469.5 vs 5.35; P < .001), than those without the deposits.
  • MACE occurred in 35 patients and were more frequent in patients with CV MSU deposits (25.9%) than in those without (12.5%; odds ratio, 2.4; = .018).
  • MACE incidence was significantly higher in patients with MSU deposits (31.8 vs 6.7 cases per 1000 patient-years).