Integrating ultrasound and clinical risk factors to predict carotid plaque vulnerability in gout patients: a machine learning approach.

Objectives: This study aimed to identify independent risk factors for carotid plaque (CP) vulnerability in patients with gout and to develop a predictive model incorporating both gout-specific and cardiovascular factors. Method: This study was designed as a retrospective cohort analysis that enrolled patients with newly diagnosed gout. These patients were retrospectively followed for a period of 1 to 2 years to evaluate the incidence of CP vulnerability. CP vulnerability was assessed using standardized ultrasound examinations and graded according to the Plaque Reporting and Data System (Plaque-RADS). Multivariate ordinal logistic regression analysis was employed to identify independent risk factors associated with CP vulnerability, with a particular focus on the impact of gout-related variables. Based on these results, a random forest prediction model was developed by integrating ultrasound imaging features and clinical variables to predict CP vulnerability. Results: Tophi (OR = 1.760, Conclusion: The presence of tophi, positive PD signals, and increased number of gout flares are significantly associated with CP vulnerability in patients with gout. The proposed machine learning model, integrating gout-specific and cardiovascular factors, provides a novel and effective approach for personalized risk stratification and management in gout patients, bridging the gap between rheumatic inflammation and cardiovascular risk assessment.