Gout Medication Improves Survival for Patients Hospitalized With Heart Failure

A common gout medication, colchicine, significantly improved survival rates for patients hospitalized with worsening heart failure, a UVA Health study found. The researchers believe colchicine could also reduce the risk for heart attack and stroke in patients with a buildup of cholesterol in their arteries.

Researchers reviewed the records of more than 1,000 patients admitted to University of Virginia Medical Center between March 2011 and February 2020 for worsening heart failure. Patients who received colchicine for a gout flare had a survival rate of 97.9%, compared with a 93.5% survival rate for patients not receiving colchicine.

“These results highlight the importance of novel inflammatory mechanisms in heart failure,” said Kenneth Bilchick, MD, MS, Professor of Cardiovascular Medicine and a clinical investigator at UVA. “The signal for benefit with colchicine in these patients was very impressive, and I expect that these findings will have quite a significant impact on clinical care in heart failure and future research for patients with this condition.”

“Heart failure is more than just a failure of the pumping function of the heart. There are other processes that are involved, especially during an acute hospitalization phase such as elevated inflammation and neuro-hormonal process. Many of the therapeutic agents for heart failure target neuro-hormonal pathways, but few if any target inflammatory pathways,” said Sula Mazimba, MD, MPH, a UVA School of Medicine researcher and cardiologist specializing in heart failure. “Colchicine is a medication that has anti-inflammatory properties that could potentially attenuate the heightened inflammation that we see in patients who are hospitalized with heart failure.”

TREATING GOUT AND HEART FAILURE

Heart failure occurs when the body fails to adequately pump blood throughout the body. Approximately 6 million Americans have heart failure, according to the American Heart Association, and the condition is responsible for more than 86,000 deaths annually.

Patients with heart failure also frequently have gout, a type of arthritis caused by a buildup of uric acid crystals in the joints. Common treatments for gout include colchicine, steroids and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, but steroids and NSAIDs are not typically given to heart failure patients because of their potential to worsen heart failure symptoms.

While colchicine is a well-established treatment for gout, the UVA research team believes the medication’s anti-inflammatory properties may also be key to improving outcomes for heart failure patients. They think that colchicine may modulate inflammation in the heart and blood vessels with potential for improving outcomes, especially in the acute phases of heart failure hospitalizations.

Additional, larger studies to further explore colchicine as a potential treatment option for heart failure are needed, but the UVA researchers are encouraged by their initial findings.

“We’re very excited about these findings, especially given that colchicine is already a widely available medication,” said Mary E. Roth, PharmD, a researcher and cardiovascular clinical pharmacist at UVA Health. “If additional studies confirm the results, colchicine could be another tool we can utilize to improve the survival of our heart failure patients.”

Reference: Roth ME, Chinn ME, Dunn SP, Bilchick KC, Mazimba S. Association of colchicine use for acute gout with clinical outcomes in acute decompensated heart failure. Clin. Cardiol. 2022. doi: 10.1002/clc.23830

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