Allopurinol use and risk of non-fatal acute myocardial infarction

Abajo, Francisco J. de; Gil, Miguel; Rodríguez, Antonio Fernández; García-Poza, P; Alvarez, Alicia; Bryant, Verónica; Garcı́a-Rodrı́guez, Luis Alberto

doi:10.1136/heartjnl-2014-306670

Cited by 48 publications

(46 citation statements)

References 28 publications

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“…This is similar to a lower risk of cardiovascular events (including MI) due to allopurinol in a longer follow-up of a randomised study documenting an impact of longer duration 45. In addition, higher allopurinol dose was associated with lower mortality in patients with heart failure29 and lower risk of MI in the general population 25. Thus, potential cardioprotective effects of allopurinol may be related to allopurinol duration and dose.…”

Section: Discussionsupporting

confidence: 63%

“…The study was limited to patients with heart failure and to US veterans, a significant issue with generalisability of study findings; specifics of study methods are not available. Our observation of potential prevention of AF with allopurinol adds to the emerging literature of its cardiovascular beneficial effect for overall cardiovascular outcomes,24 myocardial infarction,25 heart failure readmission or death,26 and mortality 27–29…”

Section: Discussionmentioning

confidence: 76%

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Allopurinol and the risk of atrial fibrillation in the elderly: a study using Medicare data

Singh

2016

Ann Rheum Dis

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 76%

Allopurinol and the risk of atrial fibrillation in the elderly: a study using Medicare data

Singh

2016

Ann Rheum Dis

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“…Finally, a recently published pharmacoepidemiological study found results close to those reported by de Abajo and colleagues,2 with allopurinol use associated with 20% reduced risk of MI 8…”

Section: Urate-lowering Therapiessupporting

confidence: 72%

“…In this context, the report from de Abajo and colleagues2 is of interest: this population-based case-control study found that allopurinol was associated with significantly reduced risk of non-fatal acute MI (OR=0.52 (95% CI 0.33 to 0.83)), mainly in men, with >180 days’ allopurinol exposure and with >300 mg dose.…”

mentioning

confidence: 98%

Allopurinol and risk of myocardial infarction

Richette

2015

Heart

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“…Epidemiological studies suggested that allopurinol might decrease morbidity and mortality in patients with congestive heart failure and a history of gout,118 119 a benefit not confirmed in a recent randomised trial of patients with heart failure and hyperuricaemia without gout 120. In addition, pharmaco-epidemiological studies report that allopurinol use is associated with an approximately 20% reduction in myocardial infarction risk 121 122. However, the task force acknowledged that additional well-conducted trials are warranted in this field, as recent studies yielded conflicting results 123 124…”

Section: Resultsmentioning

confidence: 99%

2016 updated EULAR evidence-based recommendations for the management of gout

et al. 2016

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BACKGROUND:\ud New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations.\ud METHODS:\ud \ud The EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries. A systematic review of the literature concerning all aspects of gout treatments was performed. Subsequently, recommendations were formulated by use of a Delphi consensus approach.\ud RESULTS:\ud \ud Three overarching principles and 11 key recommendations were generated. For the treatment of flare, colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), oral or intra-articular steroids or a combination are recommended. In patients with frequent flare and contraindications to colchicine, NSAIDs and corticosteroids, an interleukin-1 blocker should be considered. In addition to education and a non-pharmacological management approach, urate-lowering therapy (ULT) should be considered from the first presentation of the disease, and serum uric acid (SUA) levels should be maintained at<6 mg/dL (360 µmol/L) and <5 mg/dL (300 µmol/L) in those with severe gout. Allopurinol is recommended as first-line ULT and its dosage should be adjusted according to renal function. If the SUA target cannot be achieved with allopurinol, then febuxostat, a uricosuric or combining a xanthine oxidase inhibitor with a uricosuric should be considered. For patients with refractory gout, pegloticase is recommended.\ud CONCLUSIONS:\ud These recommendations aim to inform physicians and patients about the non-pharmacological and pharmacological treatments for gout and to provide the best strategies to achieve the predefined urate target to cure the disease

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Allopurinol use and risk of non-fatal acute myocardial infarction

Abstract: The present study supports the hypothesis that allopurinol is associated with a reduced risk of non-fatal AMI, which seems to be dose-dependent and duration-dependent.

Cited by 48 publications

References 28 publications

Allopurinol and the risk of atrial fibrillation in the elderly: a study using Medicare data

Allopurinol and the risk of atrial fibrillation in the elderly: a study using Medicare data

Allopurinol and risk of myocardial infarction

2016 updated EULAR evidence-based recommendations for the management of gout

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