TY - JOUR
T1 - Coagulation in gout
T2 - is there a link with disease activity?
AU - Vedder, Daisy
AU - Gerritsen, Martijn
AU - Meijers, Joost C. M.
AU - Nurmohamed, Michael T.
N1 - Funding Information: We are grateful to all patients participating in the “Reade gout cohort” and all rheumatologists from Reade Amsterdam for the recruitment. We want to thank Grunenthal for the financial support of this cohort. Funding Information: This work was supported by Grunenthal. This cohort is an investigator-initiated study and therefore no grant/award number can be provided. The research contract with Grunenthal is available upon request. Grunenthal Netherlands Publisher Copyright: © 2022, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - Objective: To investigate the coagulation system in gout patients and associations between disease activity and levels of coagulation markers. Methods: A prospective cohort study was performed with data from 30 Dutch gout patients. Levels of coagulation markers including APTT, PT, D-dimer, prothrombin F1 + 2, von Willebrand factor, and thrombin generation parameters were analyzed at baseline and 1-year visit. These markers were related to clinical markers of gout disease activity including the Gout Activity Score (GAS). Our hypothesis was that patients with gout and active disease have increased levels of coagulation markers and that a decrease in disease activity would lead to normalization of coagulation activity. Results: A higher GAS was associated with increased levels of thrombin generation parameters including ETP (ß = 0.48, p = 0.01), peak thrombin (ß = 0.60, p = 0.001), and velocity index (ß = 0.57, p = 0.002). Tophaceous gout and higher SUA levels were associated with thrombin generation parameters. After 1 year, thrombin generation parameters showed a small procoagulant trend despite a moderate decrease in disease activity. Prospectively measured changes in disease activity according to the GAS were not associated with any of the coagulation markers. Conclusion: Patients with active gout have higher levels of thrombin generation markers, indicating a link between disease activity and coagulation. A change in disease activity after 1 year was not associated with significant changes in coagulation markers, probably due to prolonged low-grade inflammation. Future studies should focus on levels of coagulation markers in comparison with the general population and the effect of adequate gout treatment.• Patients with gout have an increased risk of cardiovascular events.• High disease activity was associated with higher levels of thrombin generation markers.• Over time, small decreases in inflammation were associated with a decrease in D-dimer and thrombin generation.
AB - Objective: To investigate the coagulation system in gout patients and associations between disease activity and levels of coagulation markers. Methods: A prospective cohort study was performed with data from 30 Dutch gout patients. Levels of coagulation markers including APTT, PT, D-dimer, prothrombin F1 + 2, von Willebrand factor, and thrombin generation parameters were analyzed at baseline and 1-year visit. These markers were related to clinical markers of gout disease activity including the Gout Activity Score (GAS). Our hypothesis was that patients with gout and active disease have increased levels of coagulation markers and that a decrease in disease activity would lead to normalization of coagulation activity. Results: A higher GAS was associated with increased levels of thrombin generation parameters including ETP (ß = 0.48, p = 0.01), peak thrombin (ß = 0.60, p = 0.001), and velocity index (ß = 0.57, p = 0.002). Tophaceous gout and higher SUA levels were associated with thrombin generation parameters. After 1 year, thrombin generation parameters showed a small procoagulant trend despite a moderate decrease in disease activity. Prospectively measured changes in disease activity according to the GAS were not associated with any of the coagulation markers. Conclusion: Patients with active gout have higher levels of thrombin generation markers, indicating a link between disease activity and coagulation. A change in disease activity after 1 year was not associated with significant changes in coagulation markers, probably due to prolonged low-grade inflammation. Future studies should focus on levels of coagulation markers in comparison with the general population and the effect of adequate gout treatment.• Patients with gout have an increased risk of cardiovascular events.• High disease activity was associated with higher levels of thrombin generation markers.• Over time, small decreases in inflammation were associated with a decrease in D-dimer and thrombin generation.
KW - Cardiovascular disease
KW - Coagulation
KW - Disease activity
KW - Gout
KW - Inflammation
UR - http://www.scopus.com/inward/record.url?scp=85123942126&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10067-022-06047-9
DO - https://doi.org/10.1007/s10067-022-06047-9
M3 - Article
C2 - 35102534
SN - 0770-3198
VL - 41
SP - 1809
EP - 1815
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 6
ER -