{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T17:17:55Z","timestamp":1793207875539,"version":"4.5.0"},"reference-count":31,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2019,9,20]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the impact of achieving serum uric acid (sUA) of &lt;0.36\u2009mmol\/L on overall and cardiovascular (CV) mortality in patients with gout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective cohort of patients with gout recruited from 1992 to 2017. Exposure was defined as the average sUA recorded during the first year of follow-up, dichotomised as \u2264 or &gt;0.36\u2009mmol\/L. Bivariate and multivariate Cox proportional hazards models were used to determine mortality risks, expressed HRs and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1193 patients, 92% were men with a mean age of 60 years, 6.8 years\u2019 disease duration, an average of three to four flares in the previous year, a mean sUA of 9.1\u2009mg\/dL at baseline and a mean follow-up 48 months; and 158 died. Crude mortality rates were significantly higher for an sUA of \u22650.36\u2009mmol\/L, 80.9 per 1000 patient-years (95%\u2009CI 59.4 to 110.3), than for an sUA of &lt;0.36\u2009mmol\/L, 25.7 per 1000 patient-years (95% CI 21.3 to 30.9). After adjustment for age, sex, CV risk factors, previous CV events, observation period and baseline sUA concentration, an sUA of \u22650.36\u2009mmol\/L was associated with elevated overall mortality (HR=2.33, 95% CI 1.60 to 3.41) and CV mortality (HR=2.05, 95% CI 1.21 to 3.45).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Failure to reach a target sUA level of 0.36\u2009mmol\/L in patients with hyperuricaemia of gout is an independent predictor of overall and CV-related mortality. Targeting sUA levels of &lt;0.36\u2009mmol\/L should be a principal goal in these high-risk patients in order to reduce CV events and to extend patient survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2019-001015","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T05:55:15Z","timestamp":1571032515000},"page":"e001015","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Failure to reach uric acid target of &lt;0.36 mmol\/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality"],"prefix":"10.1136","volume":"5","author":[{"given":"Fernando","family":"P\u00e9rez Ruiz","sequence":"first","affiliation":[{"name":"Department of Rheumatolgy, Hospital Universitario Cruces, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2132-4074","authenticated-orcid":false,"given":"Pascal","family":"Richette","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, Hopital Lariboisiere Centre Viggo Petersen, Paris, France"},{"name":"Inserm UMR1132 Bioscar, Universite Paris Diderot UFR de Medecine, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin G","family":"Stack","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital Limerick, Limerick, Ireland"},{"name":"Graduate Entry Medical School, University of Limerick, Limerick, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravichandra","family":"Karra Gurunath","sequence":"additional","affiliation":[{"name":"Gr\u00fcnenthal GMBH, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma Jesus","family":"Garc\u00eda de Y\u00e9benes","sequence":"additional","affiliation":[{"name":"Instituto de Salud Musculoesquel\u00e9tica, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loreto","family":"Carmona","sequence":"additional","affiliation":[{"name":"Instituto de Salud Musculoesquel\u00e9tica, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,13]]},"reference":[{"key":"2025090312394868000_5.2.e001015.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2010.10.004"},{"key":"2025090312394868000_5.2.e001015.2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313514895"},{"key":"2025090312394868000_5.2.e001015.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-011-0234-2"},{"key":"2025090312394868000_5.2.e001015.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202421"},{"key":"2025090312394868000_5.2.e001015.5","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1002\/acr.23147","article-title":"Illness perceptions and mortality in patients with gout: a prospective observational study","volume":"69","author":"Serlachius","year":"2017","journal-title":"Arthritis Care Res"},{"key":"2025090312394868000_5.2.e001015.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0145193","article-title":"Effect of urate-lowering therapy on all-cause and cardiovascular mortality in hyperuricemic patients without gout: a case-matched cohort study","volume":"10","author":"Chen","year":"2015","journal-title":"PLoS One"},{"key":"2025090312394868000_5.2.e001015.7","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-207984"},{"key":"2025090312394868000_5.2.e001015.8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.7326\/M16-2401","article-title":"To treat or not to treat (to target) in gout","volume":"166","author":"Neogi","year":"2017","journal-title":"Ann Intern Med"},{"key":"2025090312394868000_5.2.e001015.9","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209467"},{"key":"2025090312394868000_5.2.e001015.10","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s40744-017-0091-1","article-title":"Improvement in diagnosis and Treat-to-Target management of hyperuricemia in gout: results from the GEMA-2 transversal study on practice","volume":"5","author":"Perez Ruiz","year":"2018","journal-title":"Rheumatol Ther"},{"key":"2025090312394868000_5.2.e001015.11","unstructured":"Osakidetza . 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