Gout and the heart: beyond comorbidities

Gout patients are well known to suffer from cardiovascular (CV) diseases, such as myocardial infarction or stroke, but it had been linked to the frequent comorbidities they present (i.e., metabolic syndrome). However, recent reports have revealed that gout independently associates with an increased incidence of CV events, leading to higher mortality. This likely relates to the persistent, subclinical inflammation due to monosodium urate crystals. Optimal management of gout, which aims at crystal dissolution, should reduce this increased CV risk, though this has not been proven yet. However, a rapid clearance of crystals through a lower serum uric acid target, well below its saturation point is worth considering, at least in patients with a high CV risk. This review will focus on analyzing the association between gout and CV disease and its proper management, addressing whether gout-specific treatment may differ in this subgroup of patients.