IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0260844.html
   My bibliography  Save this article

Allopurinol to reduce cardiovascular morbidity and mortality: A systematic review and meta-analysis

Author

Listed:
  • Karel H van der Pol
  • Kimberley E Wever
  • Mariette Verbakel
  • Frank L J Visseren
  • Jan H Cornel
  • Gerard A Rongen

Abstract

Aims: To compare the effectiveness of allopurinol with no treatment or placebo for the prevention of cardiovascular events in hyperuricemic patients. Methods and results: Pubmed, Web of Science and Cochrane library were searched from inception until July 2020. Randomized controlled trials (RCT) and observational studies in hyperuricemic patients without significant renal disease and treated with allopurinol, versus placebo or no treatment were included. Outcome measures were cardiovascular mortality, myocardial infarction, stroke, or a combined endpoint (CM/MI/S). For RCT’s a random effects meta-analysis was performed. For observational studies a narrative synthesis was performed. Of the original 1995 references we ultimately included 26 RCT’s and 21 observational studies. We found a significantly reduced risk of combined endpoint (Risk Ratio 0.65 [95% CI] [0.46 to 0.91]; p = 0.012) and myocardial infarction (RR 0.47 [0.27 to 0.80]; p = 0.01) in the allopurinol group compared to controls. We found no significant effect of allopurinol on stroke or cardiovascular mortality. Of the 15 observational studies with sufficient quality, allopurinol was associated with reduced cardiovascular mortality in 1 out of 3 studies that reported this outcome, myocardial infarction in 6 out of 8, stroke in 4 out of 7, and combined end-point in 2 out of 2. Cardiovascular benefit was only observed when allopurinol therapy was prolonged for more than 6 months and when an appropriate allopurinol dose was administered (300 mg or more/day) or sufficient reduction of serum urate concentration was achieved (

Suggested Citation

  • Karel H van der Pol & Kimberley E Wever & Mariette Verbakel & Frank L J Visseren & Jan H Cornel & Gerard A Rongen, 2021. "Allopurinol to reduce cardiovascular morbidity and mortality: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-19, December.
    • Handle: RePEc:plo:pone00:0260844
    DOI: 10.1371/journal.pone.0260844
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0260844
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0260844&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0260844?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wallace, Byron C. & Dahabreh, Issa J. & Trikalinos, Thomas A. & Lau, Joseph & Trow, Paul & Schmid, Christopher H., 2012. "Closing the Gap between Methodologists and End-Users: R as a Computational Back-End," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 49(i05).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gabriel Alves Vieira & Jacqueline Leta, 2024. "biblioverlap: an R package for document matching across bibliographic datasets," Scientometrics, Springer;Akadémiai Kiadó, vol. 129(7), pages 4513-4527, July.
    2. Serena Vi & Damon Pham & Yu Yian Marina Du & Himanshu Arora & Santosh Kumar Tadakamadla, 2021. "Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(8), pages 1-15, April.
    3. Shruti Murthy & Myron Anthony Godinho & Vasudeva Guddattu & Leslie Edward Simon Lewis & N Sreekumaran Nair, 2019. "Risk factors of neonatal sepsis in India: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-26, April.
    4. Rami M Elshazli & Eman A Toraih & Abdelaziz Elgaml & Mohammed El-Mowafy & Mohamed El-Mesery & Mohamed N Amin & Mohammad H Hussein & Mary T Killackey & Manal S Fawzy & Emad Kandil, 2020. "Diagnostic and prognostic value of hematological and immunological markers in COVID-19 infection: A meta-analysis of 6320 patients," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-20, August.
    5. Kai Wei Lee & Sook Fan Yap & Yun Fong Ngeow & Munn Sann Lye, 2021. "COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(7), pages 1-25, March.
    6. Kai Wei Lee & Siew Mooi Ching & Navin Kumar Devaraj & Seng Choi Chong & Sook Yee Lim & Hong Chuan Loh & Habibah Abdul Hamid, 2020. "Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies," IJERPH, MDPI, vol. 17(11), pages 1-15, May.
    7. Clinton Sanchez & Brian Sundermeier & Kenneth Gray & Robert J Calin-Jageman, 2017. "Direct replication of Gervais & Norenzayan (2012): No evidence that analytic thinking decreases religious belief," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-8, February.
    8. Vanja Dimitrijević & Tijana Šćepanović & Vukadin Milankov & Miroslav Milankov & Patrik Drid, 2022. "Effects of Corrective Exercises on Lumbar Lordotic Angle Correction: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(8), pages 1-12, April.
    9. Raluca Tomsa & Smaranda Gutu & Daniel Cojocaru & Belén Gutiérrez-Bermejo & Noelia Flores & Cristina Jenaro, 2021. "Prevalence of Sexual Abuse in Adults with Intellectual Disability: Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(4), pages 1-17, February.
    10. Valero-Mora, Pedro M. & Ledesma, Ruben, 2012. "Graphical User Interfaces for R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 49(i01).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0260844. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.