{"id":5806,"date":"2019-02-08T00:00:00","date_gmt":"2019-02-08T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/association-between-allopurinol-and-cardiovascular-outcomes-and-all-cause-mortality-in-diabetes-a-retrospective-population-based-cohort-study\/"},"modified":"2023-06-14T19:25:35","modified_gmt":"2023-06-14T23:25:35","slug":"association-between-allopurinol-and-cardiovascular-outcomes-and-all-cause-mortality-in-diabetes-a-retrospective-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-between-allopurinol-and-cardiovascular-outcomes-and-all-cause-mortality-in-diabetes-a-retrospective-population-based-cohort-study\/","title":{"rendered":"Association between allopurinol and cardiovascular outcomes and all-cause mortality in diabetes: a retrospective, population-based cohort study"},"content":{"rendered":"<p><strong>Aims <\/strong>&#x2014; To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol-treated diabetes cohort.<\/p>\n<p><span class=\"bold\">Materials and Methods <\/span>&#x2014; We conducted a population-based retrospective cohort study in Ontario, Canada. Eligible subjects were &#x2265;66 years old with diabetes and a first prescription for allopurinol between 1 April, 2002 and 31 March, 2012 and were followed until 31 March, 2016. The primary outcome was a composite: all-cause mortality, non-fatal cardiovascular event (myocardial infarction, revascularization procedure, or stroke) or congestive heart failure (CHF). Secondary outcomes were components of the primary outcome and pneumonia as a negative tracer. Allopurinol was modelled as time-varying exposed versus unexposed, daily dose category and cumulative dose using sex-specific multivariable Cox proportional hazards models.<\/p>\n<p><strong>Results <\/strong>&#x2014; Over a median follow-up of 4.65 years (interquartile range 1.79-7.81), 16 266\/23 103 males and 10 571\/15 313 females experienced the primary outcome. Allopurinol was associated with a reduction in the primary outcome [adjusted hazard ratios (aHR) 0.77 (95% confidence interval 0.75-0.80) and 0.81 (0.78-0.84) for males and females, respectively], driven by marked reductions in all-cause mortality and modest reductions in cardiovascular events\/CHF. There was no effect of cumulative allopurinol dose on any outcome, and allopurinol was also associated with reduced risk of pneumonia in males [aHR 0.88 (0.83, 0.93)].<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Allopurinol was associated with reduced mortality and cardiovascular outcomes. However, lack of cumulative dose effect and a positive tracer outcome in males suggests residual bias. Future research assessing whether allopurinol prevents vascular complications in diabetes requires a clinical trial.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Aims &#x2014; To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol-treated diabetes cohort. Materials and Methods &#x2014; We conducted a population-based retrospective cohort study in Ontario, Canada. Eligible subjects were &#x2265;66 years old with diabetes and a first prescription for allopurinol between 1 April, 2002 and 31 March, 2012 and [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-5806","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Weisman A, Tomlinson GA, Lipscombe LL, Perkins BA, Hawker GA. <em>Diabetes Obes Metab<\/em>. 2019; 21(6):1322-9. Epub 2019 Feb 8.","source_url":"","ices_scientist":[1295,1267,1125],"site":[6733],"research_program":[6746],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"5BCE5CBF-AFC7-478F-9927-21C7ABB2353F","sitecore_item_name":"Association-between-allopurinol-and-cardiovascular-outcomes-and-all-cause-mortality-in-diabetes","sitecore_field_values":"{\n  \"Title\": \"Association between allopurinol and cardiovascular outcomes and all-cause mortality in diabetes: a retrospective, population-based cohort study\",\n  \"Short title\": \"Association between allopurinol and\",\n  \"Summary\": \"The impact of allopurinol has not been well-studied. This study assessed the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol-treated diabetes cohort.\",\n  \"Citation\": \"<p>Weisman A, Tomlinson GA, Lipscombe LL, Perkins BA, Hawker GA. <em>Diabetes Obes Metab<\/em>. 2019; 21(6):1322-9. Epub 2019 Feb 8.<\/p>\",\n  \"Abstract\": \"<p><strong>Aims <\/strong>&mdash; To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol-treated diabetes cohort.<\/p>n<p><span class=\"bold\">Materials and Methods <\/span>&mdash; We conducted a population-based retrospective cohort study in Ontario, Canada. Eligible subjects were &ge;66 years old with diabetes and a first prescription for allopurinol between 1 April, 2002 and 31 March, 2012 and were followed until 31 March, 2016. The primary outcome was a composite: all-cause mortality, non-fatal cardiovascular event (myocardial infarction, revascularization procedure, or stroke) or congestive heart failure (CHF). Secondary outcomes were components of the primary outcome and pneumonia as a negative tracer. Allopurinol was modelled as time-varying exposed versus unexposed, daily dose category and cumulative dose using sex-specific multivariable Cox proportional hazards models.<\/p>n<p><strong>Results <\/strong>&mdash; Over a median follow-up of 4.65 years (interquartile range 1.79-7.81), 16 266\/23 103 males and 10 571\/15 313 females experienced the primary outcome. Allopurinol was associated with a reduction in the primary outcome [adjusted hazard ratios (aHR) 0.77 (95% confidence interval 0.75-0.80) and 0.81 (0.78-0.84) for males and females, respectively], driven by marked reductions in all-cause mortality and modest reductions in cardiovascular events\/CHF. There was no effect of cumulative allopurinol dose on any outcome, and allopurinol was also associated with reduced risk of pneumonia in males [aHR 0.88 (0.83, 0.93)].<\/p>n<p><strong>Conclusions<\/strong> &mdash; Allopurinol was associated with reduced mortality and cardiovascular outcomes. However, lack of cumulative dose effect and a positive tracer outcome in males suggests residual bias. Future research assessing whether allopurinol prevents vascular complications in diabetes requires a clinical trial.<\/p>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{DC2C9ADE-ED70-4834-A8AC-A7271C6E48F5}|{4D93CE4E-174C-4555-9897-9FAE06C5C9CE}|{C6CF5BEE-928B-4481-A4C0-41FE159B40F5}\",\n  \"Posted Date\": \"20190208T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2019\/February\/Association-between-allopurinol-and-cardiovascular-outcomes-and-all-cause-mortality-in-diabetes"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association between allopurinol and cardiovascular outcomes and all-cause mortality in diabetes: a retrospective, population-based cohort study<\/title>\n<meta name=\"description\" content=\"Aims &#x2014; To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol-treated diabetes cohort. 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