Risk of non-fatal acute myocardial infarction associated with allopurinol
| Cases (%) N=3171 | Controls (%) N=18 525 | Non-adjusted* OR (95% CI) | Adjusted† OR (95% CI) | |
|---|---|---|---|---|
| Non-use | 3105 (97.9) | 18 171 (98.1) | 1 (ref.) | 1 (ref.) |
| Any time use | 66 (2.1) | 354 (2.1) | 1.08 (0.83 to 1.42) | 0.72 (0.52 to 0.99) |
| Recency (days) | ||||
| Current use (<31) | 26 (0.82) | 190 (1.0) | 0.80 (0.52 to 1.20) | 0.52 (0.33 to 0.83) |
| Recent use (31–365) | 25 (0.79) | 103 (0.56) | 1.41 (0.91 to 2.19) | 0.99 (0.61 to 1.61) |
| Past use (>365) | 15 (0.47) | 61 (0.33) | 1.42 (0.80 to 2.51) | 0.88 (0.47 to 1.65) |
| Allopurinol duration (consecutive prescriptions)‡ (days) | ||||
| <31 | 12 (0.38) | 40 (0.22) | 1.76 (0.92 to 3.36) | 1.12 (0.55 to 2.29) |
| 31–180 | 9 (0.28) | 57 (0.31) | 0.92 (0.46 to 1.87) | 0.61 (0.29 to 1.29) |
| >180 | 5 (0.16) | 93 (0.50) | 0.31 (0.12 to 0.77) | 0.21 (0.08 to 0.53) |
| p for trend=0.001 | ||||
| Allopurinol duration (since first prescription)‡ (days) | ||||
| <31 | 4 (0.13) | 13 (0.07) | 1.81 (0.59 to 5.54) | 0.92 (0.27 to 3.16) |
| 31–180 | 9 (0.28) | 53 (0.29) | 1.00 (0.49 to 2.02) | 0.73 (0.34 to 1.55) |
| >180 | 13 (0.41) | 124 (0.67) | 0.61 (0.34 to 1.08) | 0.39 (0.21 to 0.73) |
| p for trend=0.003 | ||||
| Allopurinol daily dose‡ (mg) | ||||
| <300 | 15 (0.47) | 85 (0.46) | 1.02 (0.59 to 1.79) | 0.67 (0.37 to 1.23) |
| 300+ | 6 (0.19) | 76 (0.41) | 0.46 (0.20 to 1.06) | 0.30 (0.13 to 0.72) |
| Unknown | 5 (0.16) | 29 (0.16) | 1.01 (0.39 to 2.59) | 0.70 (0.25 to 1.96) |
*Model adjusted only for the matching variables (sex, age and calendar year).
†Fully adjusted model: matching variables plus the following factors: ischaemic heart disease, cerebrovascular events (including transient ischaemic attack and stroke), peripheral artery disease, heart failure, diabetes (including use of glucose-lowering drugs), dyslipidemia (including use of lipid-lowering drugs), hyperuricaemia, gout, hypertension, smoking, rheumatoid arthritis, renal failure; and use of the following drugs: non-steroidal anti-inflammatory drugs, metamizole, paracetamol, corticosteroids, colchicine, alpha-blockers, calcium-channel blockers, beta-blockers, ACE inhibitors, angiotensin II receptor blockers, diuretics, nitrates, low-dose aspirin, non-aspirin antiplatelet drugs, oral anticoagulants, inhaled beta agonist, antidepressants, acid-suppressing drugs and sexual hormones.
‡Among current users of allopurinol.