Evidence map›Paper›PMID 28288564›Full record

ArticleBMC cardiovascular disorders2017

Allopurinol use and the risk of acute cardiovascular events in patients with gout and diabetes.

Jasvinder A Singh, Rekha Ramachandaran, Shaohua Yu, Jeffrey R Curtis

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Jasvinder A SinghMedicine Service, VA Medical Center, 700 19th St S, Birmingham, AL, 35233, USA. Jasvinder.md@gmail.com.
Rekha RamachandaranDepartment of Medicine at School of Medicine, University of Alabama at Birmingham, 510, 20th street South, Faculty office tower (FOT), Birmingham, AL, 35294, USA.
Shaohua YuDepartment of Medicine at School of Medicine, University of Alabama at Birmingham, 510, 20th street South, Faculty office tower (FOT), Birmingham, AL, 35294, USA.
Jeffrey R CurtisDepartment of Medicine at School of Medicine, University of Alabama at Birmingham, 510, 20th street South, Faculty office tower (FOT), Birmingham, AL, 35294, USA.
University of Alabama at Birmingham · USBirmingham VA Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFew studies, if any, have examined cardiovascular outcomes in patients with diabetes and gout. Both diabetes and gout are risk factors for cardiovascular disease. The objective of this study was to examine the effect of allopurinol on the risk of incident acute cardiovascular events in patients with gout and diabetes.

methodsWe used the 2007-2010 Multi-Payer Claims Database (MPCD) that linked health plan data from national commercial and governmental insurances, representing beneficiaries with United Healthcare, Medicare, or Medicaid coverage. In patients with gout and diabetes, we assessed the current allopurinol use, defined as a new filled prescription for allopurinol, as the main predictor of interest. Our outcome of interest was the occurrence of the first Incident hospitalized myocardial infarction (MI) or stroke (composite acute cardiovascular event), after which observations were censored. We employed multivariable-adjusted Cox proportional hazards models that simultaneously adjusted for patient demographics, cardiovascular risk factors and other medical comorbidities. We calculated hazard ratios [HR] (95% confidence intervals [CI]) for incident composite (MI or stroke) acute cardiovascular events. We performed sensitivity analyses that additionally adjusted for the presence of immune diseases and colchicine use, as potential confounders.

resultsThere were 2,053,185 person days (5621.3 person years) of current allopurinol use and 1,671,583 person days (4576.5 person years) of prior allopurinol use. There were 158 incident MIs or strokes in current and 151 in prior allopurinol users, respectively. Compared to previous allopurinol users, current allopurinol users had significantly lower adjusted hazard of incident acute cardiovascular events (incident stroke or MI), with an HR of 0.67 (95% CI, 0.53, 0.84). Sensitivity analyses, additionally adjusted for immune diseases or colchicine use, confirmed this association.

conclusionsCurrent allopurinol use protected against the occurrence of acute cardiovascular events in patients with gout and diabetes. The underlying mechanisms for this potential cardio-protective effect of allopurinol need further exploration.

Indexed as

Acute DiseaseAftercareAgedAged, 80 and overAllopurinolCardiovascular DiseasesDiabetes MellitusFemaleFree Radical ScavengersGoutHumansMaleMiddle AgedMorbidityPrognosisProportional Hazards ModelsAllopurinolFree Radical ScavengersAcute cardiovascular eventsAllopurinolDiabetesGoutMyocardial infarctionPredictorsStroke

Identifiers

PMID28288564
PMCPMC5348884
OpenAlexW2595745819

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.