Allopurinol therapy in gout patients does not associate with beneficial cardiovascular outcomes: A population-based matched-cohort study

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Title:	Allopurinol therapy in gout patients does not associate with beneficial cardiovascular outcomes: A population-based matched-cohort study
Authors:	洪炯宗;Kok, Victor C.;Horng, Jorng-Tzong;Chang, Wan-Shan;Hong, Ya-Fang;Chang, Tzu-Hao
Contributors:	資訊電機學院資訊工程學系
Keywords:	Adult;Aged;Aged, 80 and over;Alcoholic beverages;Allopurinol;Allopurinol - adverse effects;Ambulatory care;Analysis;Angina pectoris;Arteriosclerosis;Atherosclerosis;Blood pressure;Body mass;Body Mass Index;Body size;Cardiac patients;Cardiovascular disease;Cardiovascular diseases;Cardiovascular Diseases - chemically induced;Cardiovascular Diseases - diagnosis;Cardiovascular Diseases - mortality;Care and treatment;Case-Control Studies;Chronic kidney failure;Cohort analysis;Comorbidity;Computer science;Confidence intervals;Development and progression;Diabetes;Diabetes mellitus;Female;Fibrillation;Follow-Up Studies;Gout;Gout - complications;Gout - drug therapy;Gout - mortality;Gout Suppressants - adverse effects;Health insurance;Health maintenance organizations;Health risk assessment;Health risks;Heart diseases;Heart failure;Hepatitis;HMOs;Humans;Hyperlipidemia;Hypertension;Hyperuricemia;Inflammation;Informatics;Kidney diseases;Kidney transplantation;Kidneys;Male;Medicine and Health Sciences;Middle Aged;Mortality;Nephrolithiasis;Oxidative stress;Patient outcomes;Patients;Population;Population studies;Population-based studies;Prognosis;Proportional Hazards Models;Public health;Purines;Retrospective Studies;Rheumatism;Risk analysis;Risk Factors;Smoking;Statistical models;Studies;Survival Rate;Therapy;Uremia;Uric acid
Date:	2014-06-04
Issue Date:	2026-04-23 13:13:28 (UTC+8)
Publisher:	Public Library of Science;United States: Public Library of Science
Abstract:	摘要： Previous studies have shown an association between gout and/or hyperuricemia and a subsequent increase in cardiovascular disease (CVD) outcomes. Allopurinol reduces vascular oxidative stress, ameliorates inflammatory state, improves endothelial function, and prevents atherosclerosis progression. Accordingly, we tested the hypothesis that a positive association between allopurinol therapy in gout patients and future cardiovascular outcomes is present using a population-based matched-cohort study design. Patients aged ≥40 years with newly diagnosed gout having no pre-existing severe form of CVD were separated into allopurinol (n = 2483) and non-allopurinol (n = 2483) groups after matching for age, gender, index date, diabetes mellitus, hypertension, hyperlipidemia, and atrial fibrillation. The two groups were also balanced in terms of uric acid nephrolithiasis, acute kidney injury, hepatitis, and Charlson comorbidity index. With a median follow-up time of 5.25 years, the allopurinol group had a modest increase in cardiovascular risk [relative risk, 1.20; 95% confidence interval (CI), 1.08-1.34]. A Cox proportional hazard model adjusted for chronic kidney disease, uremia, and gastric ulcer gave a hazard ratio (HR) for cardiovascular outcomes of 1.25 (95% CI, 1.10-1.41) in gout patients receiving allopurinol compared with the non-allopurinol group. In further analysis of patients receiving urate-lowering therapy, the uricosuric agent group (n = 1713) had an adjusted HR of 0.83 (0.73-0.95) for cardiovascular events compared with the allopurinol group. The current population-based matched-cohort study did not support the association between allopurinol therapy in gout patients with normal risk for cardiovascular sequels and beneficial future cardiovascular outcomes. Several important risk factors for cardiovascular disease, such as smoking, alcohol consumption, body mass index, blood pressure were not obtainable in the current retrospective cohort study, thus could potentially bias the effect estimate. 其他題名： PLoS One 出版者： United States: Public Library of Science 出版日期： 2014-06-04 出處： PloS one, 2014-06, Vol.9 (6), p.e99102 資源來源： Agricultural & Environmental Science Collection 版權： COPYRIGHT 2014 Public Library of Science 版權： 2014 Kok et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 版權： 2014 Kok et al 2014 Kok et al 識別號： ISSN: 1932-6203 識別號： EISSN: 1932-6203 識別號： DOI: 10.1371/journal.pone.0099102 識別號： PMID: 24897240
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