title: Allopurinol, benzbromarone and risk of coronary heart disease in gout patients: A population-based study.
abstract: BACKGROUND
  The effect of gout on the risk of developing coronary artery disease (CAD) is uncertain. Some studies have found that gout is a risk factor for acute myocardial infarction. This study examined the changes in risk of CAD in gout patients taking allopurinol and/or benzbromarone, and analyzed the dose-response relationship of both drugs with CAD incidence.
  
  
  METHODS
  The medical records of one million subjects from 2000 to 2011 were provided by the Taiwan National Health Insurance Research Database. Cox proportional hazard ratio was used to compare the risk of CAD in gout patients taking allopurinol or/and benzbromarone with those taking neither drug. Hazard ratios (HR) were adjusted for possible confounding factors, including age, gender, hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease, and relevant medications.
  
  
  RESULTS
  Of 8047 gout patients, 1422 were treated with allopurinol (Group A), 4141 with benzbromarone (Group B), and 2484 with both drugs (Group A/B) during the follow-up period. Our results showed the incidence of CAD after adjusting for covariates for Group A, Group B, and Group A/B did not significantly differ from the comparison group. However, after adjustment for covariates in dose-response analyses, treatment with over 270 defined daily doses (DDDs) of allopurinol, and over 360 DDDs of benzbromarone, was associated with a significantly reduced risk of CAD.
  
  
  CONCLUSIONS
  We found that the use of allopurinol and benzbromarone, whether alone or in combination, had a linear dose-response relationship between the numbers of defined daily doses and the risk of CAD, especially in higher DDDs.
authors.affiliation: Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Laboratory Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Hsiu-Chen
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Clinical Laboratory, Tokyo University Hospital, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Daimon
authors.affiliation: School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ching-Hung
authors.initials: CH
authors.lastname: Wang
authors.affiliation: School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ho
authors.affiliation: School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yow-Shieng
authors.initials: YS
authors.lastname: Uang
authors.affiliation: Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: sjchiang1117@seed.net.tw.
authors.forename: Shuo-Ju
authors.initials: SJ
authors.lastname: Chiang
authors.affiliation: School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: shiuan@tmu.edu.tw.
authors.forename: Li-Hsuan
authors.initials: LH
authors.lastname: Wang
mesh_terms: D000493:Allopurinol / Q000008:administration & dosage*; D001553:Benzbromarone / Q000008:administration & dosage*; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006073:Gout / Q000150:complications* / Q000188:drug therapy; D006074:Gout Suppressants / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D014528:Uricosuric Agents / Q000008:administration & dosage
chemical_list: D006074:Gout Suppressants; D014528:Uricosuric Agents; D014527:Uric Acid; D001553:Benzbromarone; D000493:Allopurinol
keywords: Anti-hyperuricemic drugs; Coronary artery disease; Dose-effect; Gout; Risk