{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:08:37Z","timestamp":1775646517825,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T00:00:00Z","timestamp":1553472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009227","name":"Department of Medicine, University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009227","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol\u2010treated diabetes cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a population\u2010based retrospective cohort study in Ontario, Canada. Eligible subjects were\u2009\u2265\u200966\u2009years 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\u2010cause mortality, non\u2010fatal 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\u2010varying exposed versus unexposed, daily dose category and cumulative dose using sex\u2010specific multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow\u2010up of 4.65\u2009years (interquartile range 1.79\u20137.81), 16\u2009266\/23 103 males and 10\u2009571\/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\u20130.80) and 0.81 (0.78\u20130.84) for males and females, respectively], driven by marked reductions in all\u2010cause 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)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.13656","type":"journal-article","created":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T05:14:43Z","timestamp":1549602883000},"page":"1322-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Association between allopurinol and cardiovascular outcomes and all\u2010cause mortality in diabetes: A retrospective, population\u2010based cohort study"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3778-653X","authenticated-orcid":false,"given":"Alanna","family":"Weisman","sequence":"first","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"ICES  Toronto Ontario Canada"},{"name":"Women's College Research Institute Women's College Hospital  Toronto 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