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Ann Rheum Dis doi:10.1136/annrheumdis-2012-202972
  • Clinical and epidemiological research
  • Extended report

Impact of allopurinol on risk of myocardial infarction

  1. 1LA-SER, Paris, France
  2. 2Conservatoire National des Arts & Métiers, Paris, France
  3. 3INSERM/Pasteur Institute, Paris, France
  4. 4Inserm U708-Neuroepidemiology, Bordeaux, France
  5. 5Université Bordeaux-Segalen, Bordeaux, France
  6. 6Coronary disease unit, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris and Paris-Descartes University, Paris, France
  7. 7LA-SER, Centre for Risk Research, Montreal, Canada
  8. 8Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
  9. 9Department of Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
  10. 10LA-SER Europe Ltd, London, UK
  11. 11Université Paris 7, UFR médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, Paris, Cedex 10, France
  12. 12Inserm U1132, Hôpital Lariboisière, Paris, Cedex 10, France
  1. Correspondence to Professor Pascal Richette, Hôpital Lariboisière, Fédération de Rhumatologie, Centre Viggo Petersen, 2, rue Ambroise Paré, Paris 75475, Cedex 10, France; pascal.richette{at}lrb.aphp.fr
  • Received 12 November 2012
  • Revised 27 November 2013
  • Accepted 14 December 2013
  • Published Online First 6 January 2014

Abstract

Background Gout therapy includes xanthine oxidase inhibitors (XOI) and colchicine, which have both been associated with decreased cardiovascular risk. However, their effects on major cardiac events, such as myocardial infarction (MI), need to be investigated further.

Objectives To investigate whether XOIs and colchicine are associated with decreased risk of MI.

Methods This case-control study compared patients with first-ever MI and matched controls. Cases were recruited from the Pharmacoepidemiological General Research on MI registry. Controls were selected from a referent population (n=8444) from general practice settings.

Results The study sample consisted of 2277 MI patients and 4849 matched controls. Use of allopurinol was reported by 3.1% of cases and 3.8 of controls, and 1.1% of cases and controls used colchicine. The adjusted OR (95% CI) for MI with allopurinol use was 0.80 (0.59 to 1.09). When using less stringent matching criteria that allowed for inclusion of 2593 cases and 5185 controls, the adjusted OR was 0.73 (0.54 to 0.99). Similar results were found on analysis by sex and hypertension status. Colchicine used was not associated with a decreased risk of MI (aOR=1.17 (0.70 to 1.93)).

Conclusions Allopurinol may be associated with a reduced risk of MI. No decreased risk of MI was found in colchicine users. Besides its urate-lowering property, allopurinol might have a cardioprotective effect.