Impact of allopurinol use on urate concentration and cardiovascular outcome.
Impact of allopurinol use on urate concentration and cardiovascular outcome.
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同硫醇使用对尿酸盐浓度和心血管结局的影响。
DOI：
10.1111/j.1365-2125.2010.03887.x
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发表时间：
2011-04
影响因子：
3.4
通讯作者：
MacDonald TM
中科院分区：
文献类型：
--
作者：
Wei L;Mackenzie IS;Chen Y;Struthers AD;MacDonald TM
通过使用降尿酸治疗（ULT）来描述尿酸测量准确的患者，并研究别嘌呤醇治疗对心血管和死亡率结果的影响。使用记录链接数据库的队列研究。该研究包括7135名年龄≥60岁的患者，在2000年至2002年期间进行了精确测量，随访至2007年。采用Cox回归模型。确定尿酸水平、分配别嘌呤醇与心血管住院和死亡率之间的关系。6442例患者未服用ULT，其中45.9%（6042例中的2774例）的尿酸浓度≤6 mg dl - 1。在1035名别嘌呤醇使用者中，44.7%（45.6%为男性，43.3%为女性）达到了目标尿酸浓度。与非ult使用者相比，别嘌呤醇使用者心血管事件的风险没有显著增加[校正危险比（HR） 1.10, 95%可信区间（CI） 0.95-1.26]和非ult使用者尿酸浓度为6 mg dl - 1（校正危险比1.07,95% CI 0.89-1.28）。在别嘌呤醇使用队列中，每1000人年，100 mg组心血管事件发生率为74.0 (95% CI 61.9-86.1)， 200 mg组为69.7(49.6-89.8)，≥300 mg组为47.6（38.4-56.9）。与低剂量（100 mg）服用者相比，高剂量（≥300 mg）服用者心血管事件的风险（调整HR 0.69, 95% CI 0.50-0.94）和死亡率（调整HR 0.75, 95% CI 0.59-0.94）显著降低。不到50%的患者服用别嘌呤醇达到目标尿酸浓度。高剂量别嘌呤醇可以更好地控制尿酸，降低心血管事件和死亡率的风险。
To characterize patients with urate measurements by urate-lowering therapy (ULT) use and to study the impact of allopurinol treatment on cardiovascular and mortality outcomes. A cohort study using a record-linkage database. The study included 7135 patients aged ≥60 years with urate measurements between 2000 and 2002 followed up until 2007. A Cox regression model was used. The association between urate levels, dispensed allopurinol and cardiovascular hospitalization and mortality was determined. Six thousand and forty-two patients were not taking ULT and 45.9% of those (2774 of 6042) had urate concentrations ≤6 mg dl−1. Among 1035 allopurinol users, 44.7% (45.6% for men and 43.3% for women) reached target urate concentration. There was no significant increased risk of cardiovascular events for allopurinol users when compared with non-ULT users [adjusted hazard ratio (HR) 1.10, 95% confidence interval (CI) 0.95–1.26] and the non-ULT group with urate >6 mg dl−1 (adjusted HR 1.07, 95% CI 0.89–1.28). Within the allopurinol use cohort, cardiovascular event rates were 74.0 (95% CI 61.9–86.1) per 1000 person years for the 100 mg group, 69.7 (49.6–89.8) for the 200 mg group and 47.6 (38.4–56.9) for the ≥300 mg group. Compared with low-dose (100 mg) users, high-dose (≥300 mg) users had significant reductions in the risk of cardiovascular events (adjusted HR 0.69, 95% CI 0.50–0.94) and mortality (adjusted HR 0.75, 95% CI 0.59–0.94). Less than 50% of patients taking allopurinol reached target urate concentration. Higher doses of allopurinol were associated with better control of urate and lower risks of both cardiovascular events and mortality.
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影响因子：
27.4
作者：
Zhang, W.;Doherty, M.;Zimmermann-Gorska, I.
通讯作者：
Zimmermann-Gorska, I.
DOI：
10.1002/art.20405
发表时间：
2004-06-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Shoji, A;Yamanaka, H;Kamatani, N
通讯作者：
Kamatani, N
影响因子：
4.2
作者：
Short, Robert A;Johnson, Richard J;Tuttle, Katherine R
通讯作者：
Tuttle, Katherine R
影响因子：
5.7
作者：
Struthers, AD;Donnan, PT;MacDonald, TM
通讯作者：
MacDonald, TM
影响因子：
120.7
作者：
Fang, J;Alderman, MH
通讯作者：
Alderman, MH