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Case–control study examining the association between allopurinol use and ischemic cerebrovascular disease
  1. Shih-Wei Lai1,2,
  2. Cheng-Li Lin1,3,
  3. Kuan-Fu Liao4,5
  1. 1 College of Medicine, China Medical University, Taichung, Taiwan
  2. 2 Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
  3. 3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  4. 4 College of Medicine, Tzu Chi University, Hualien, Taiwan
  5. 5 Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
  1. Correspondence to Dr Kuan-Fu Liao; kuanfuliaog{at}


Few studies focus on the relationship between allopurinol and ischemic cerebrovascular disease. The goal of the study was to investigate the association of long-term therapy of allopurinol with the first-time attack of ischemic cerebrovascular disease in Taiwan. We performed a case–control study using the database of the Taiwan National Health Insurance Program. The case group included 14,937 subjects aged 20–84 years with the first-time attack of ischemic cerebrovascular disease from 2000 to 2013. The control group included 14,937 sex-matched and age-matched subjects aged 20–84 years without any type of cerebrovascular disease. Ever use of allopurinol was defined as subjects who had at least a prescription for allopurinol before the index date. The OR and the 95% CI for ischemic cerebrovascular disease associated with allopurinol use were measured by the multivariable logistic regression model. The adjusted OR of ischemic cerebrovascular disease was 0.992 (95% CI 0.989 to 0.996) for subjects with increasing cumulative duration of allopurinol use for every 1 month, compared with never use. In a further analysis, the adjusted OR of ischemic cerebrovascular disease was 0.74 (95% CI 0.57 to 0.96) for cumulative duration of allopurinol use >3 years, compared with never use. Our findings suggest that lone-term therapy of allopurinol >3 years is associated with decreased risk of the first-time attack of ischemic cerebrovascular disease, compared with no allopurinol therapy.

  • cardiovascular diseases

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  • Contributors SWL contributed to the conception of the article, initiated the draft of the article, and revised the article. CLL and KFL conducted data analysis and participated in data interpretation.

  • Funding This study was supported in part by the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004) and China Medical University Hospital (DMR-107-192).

  • Disclaimer The funding agencies did not influence the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved by the Research Ethics Committee of China Medical University and Hospital in Taiwan (CMUH-104-REC2-115).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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