{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T08:29:17Z","timestamp":1786868957743,"version":"build-2736575974"},"reference-count":47,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005689","name":"G\u00f6teborgs L\u00e4kares\u00e4llskap","doi-asserted-by":"publisher","award":["985401"],"award-info":[{"award-number":["985401"]}],"id":[{"id":"10.13039\/501100005689","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt- Lungfonden","doi-asserted-by":"crossref","award":["20230630"],"award-info":[{"award-number":["20230630"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008448","name":"Rune och Ulla Aml\u00f6vs Stiftelse f\u00f6r Neurologisk och Reumatologisk Forskning","doi-asserted-by":"publisher","award":["2023-420"],"award-info":[{"award-number":["2023-420"]}],"id":[{"id":"10.13039\/100008448","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","award":["R-995247"],"award-info":[{"award-number":["R-995247"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,2,8]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the impact of allopurinol use on the risk of first-ever acute coronary syndrome (ACS) event in patients with gout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using national and regional register data, we included all patients with a gout diagnosis at primary or specialised care in Western Sweden in the period 2007\u20132017 (n=18\u2009862; 67% male patients). Patients with a prior history of coronary heart disease (CHD) were excluded. Follow-up started at the first gout diagnosis and ended at the first-ever ACS event, death or study end. The main outcome was the risk of first-ever ACS in: (1) allopurinol users versus non-users, by defining three categories of allopurinol exposure: exposed to 100\u2009mg, &gt;100\u2009mg and no exposure (reference) and (2) allopurinol initiators (within 125 days) versus long-term users (reference). Multivariable logistic regression analysis was used to calculate ORs and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In analysis 1 (n=18\u2009862), 15.3% (n=2892) were exposed to 100\u2009mg, 9.1% (n=1717) to &gt;100\u2009mg and 75.6% (n=14\u2009253) were not exposed. Allopurinol users were older and had more comorbidities compared with non-users. Allopurinol exposure (100\u2009mg and &gt;100\u2009mg) was associated with significantly lower odds of first-ever ACS (OR 0.77; 95% CI 0.63 to 0.94, and OR 0.61; 95% CI 0.47 to 0.81, respectively). In Analysis 2, allopurinol initiators (n=489) had significantly higher odds of first-ever ACS compared with long-term users (n=2916) (OR 1.68; 95% CI 1.03 to 2.75).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with gout and without CHD, long-term allopurinol use protects against first-ever ACS compared with non-users. In contrast, allopurinol initiators, possibly having more systemic inflammation, had a higher risk of first-ever ACS compared with long-term users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-092522","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T23:21:17Z","timestamp":1740698477000},"page":"e092522","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Allopurinol use and risk of acute coronary syndrome in gout patients: a population-based cohort study in Sweden"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2349-8820","authenticated-orcid":false,"given":"Panagiota","family":"Drivelegka","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Inflammation Research, University of Gothenburg Sahlgrenska Academy, Goteborg, 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