May 13, 2016
Findings of a new study suggest that long-term use of allopurinol is associated with reduced risk of incident atrial fibrillation (AF) in older adults.
Allopurinol is a uric acid reducer used for the treatment of gout and kidney stones. However, recent research has shown that the drug may have potential cardioprotective properties, including improved outcomes for myocardial infarction, heart failure, and mortality.
To examine the effects of allopurinol on risk of AF in older adults, Jasvinder A Singh and Shaohua Yu (University of Alabama, Birmingham) used a random 5% sample of Medicare claims data from 2006 to 2012 to identify patients with new exposure to allopurinol after at least 365 days of no exposure and who experienced an occurrence of incident AF. Out of 8569 beneficiaries, 9244 episodes of incident allopurinol use were identified, and 1366 of these had incident AF.
To examine the association between use of the drug and incident AF, periods of allopurinol use were compared with periods of no allopurinol use. Compared with no allopurinol use, longer allopurinol use of 180 days to 2 years and longer than 2 years were associated with decreased risk of AF (hazard ratios, 0.85 and 0.65, respectively; 95% CI, 0.73-0.99 and 0.52-0.82, respectively).
However, risks of AF were significantly greater in beneficiaries with older age (age 75-85 years and age >85 years), higher Charlson index score (indicating a greater comorbidity-related mortality risk) and concurrent use of beta blockers.
The study findings were reported in Annals of the Rheumatic Diseases.
The authors of the study suggest that future research be done to assess the mechanisms underlying the beneficial effects of allopurinol.
Singh JA, Yu S. Allopurinol and the risk of atrial fibrillation in the elderly: a study using Medicare data [published online ahead of print May 10, 2016]. Ann Rheum Dis. doi:10.1136/annrheumdis-2015-209008.