Gout is a risk factor for myocardial infarction along with risk factors such as advanced age and a history of diabetes mellitus. Common risk factors for coronary heart disease as well as myocardial infarction (MI) include male gender characteristics, increasing age, obesity, diabetes and a history of hypertension. Patients with gout, the most common inflammatory joint disease, are often accompanied by the above risk factors for MI. To clarify the interconnection between gout and MI, Chang-Fu Kuo et al. from the Department of Rheumatology and Allergic Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, conducted a cohort study based on the entire Taiwan population. The results of the study were published in the January 2013 issue of Rheumatology. The study found that gout was an independent risk factor for MI and that gout increased the risk of MI even in patients who were relatively young or without cardiovascular risk factors. The researchers’ study data were obtained from the Taiwan Health Insurance Database. Adults aged >20 years with no history of MI were included in the study. Identification of patients with gout was dependent on physician diagnosis and documentation of medication. The risk of MI in patients with gout was assessed using a multifactorial Cox proportional hazards model. A total of 704,503 patients were included in the study, of whom 26,556 (3.8%) had gout. Among all study subjects, 3718 patients (463 gout patients and 3255 non-gout patients) developed MI, of which 299 patients (35 gout patients and 264 non-gout patients) died. the incidence of MI was 2.20 per 1000 patient-years in gout patients and 0.60 per 1000 patient-years in non-gout patients ( P < 0.001 by time-rank test). Gout was associated with MIs [hazard ratio (HR) 1.23] and nonfatal MIs (HR 1.26) after adjustment for age, sex, history of diabetes, history of hypertension, history of coronary heart disease (CHD), history of smoking, and history of end-stage renal disease. After adjustment for age and sex, patients with gout without cardiovascular risk factors had a hazard ratio for concurrent MIs of 1.84 (95% CI 1.51-2.24) and a hazard ratio for concurrent nonfatal MIs of 1.80 (95% CI 1.49-3.95). In addition, the risk of MI was found to increase with age in this study population. The investigators concluded that gout is an independent risk factor for MI and that gout increases the risk of MI even in patients who are relatively young or without cardiovascular risk factors.