Jasvinder A Singh and John D Cleveland
Alabama VA Medical Center, USA University of Alabama at Birmingham, USA
Posters & Accepted Abstracts: Interv Cardiol J
Objective: Gout is associated with a higher risk of atrial fibrillation (AF).The main objective of the study was to find the comparative effectiveness of allopurinol or febuxostat in reducing the AF risk which is unknown.
Methods: We used the 5% medicare beneficiary cohort (�65 years) from 2006-2012 to identify people with a new filled prescription for allopurinol or febuxostat, with a baseline period of 365 days without either medication. We used 5:1 propensity-matched Cox regression analyses to assess whether allopurinol use differed from febuxostat use regarding the hazard ratio (HR) of incident AF.
Results: We found 25,732 eligible episodes in 23,135 beneficiaries. Of these, 2,311 incident allopurinol or febuxostat use episodes (9%) ended in incident of AF with crude incidence rates of 8.0 and 10.5 per 100 person-years, respectively. In propensity-matched analyses, compared to allopurinol, febuxostat was associated with higher hazard ratio (HR) of AF, 1.25 (95% CI: 1.05, 1.48). Compared to allopurinol <200 mg/day, febuxostat 80 mg/day was associated with significantly higher HR of AF, 1.62 (95% CI: 1.16, 2.27), but not febuxostat 40 mg/day or higher allopurinol doses. Compared to 1-180 days of allopurinol use, febuxostat use for 1-180 days was associated with significantly higher HR of AF, 1.36 (95% CI: 1.10, 1.67), but longer durations were not.
Conclusions: Febuxostat was associated with a higher risk of AF compared to allopurinol in older adults. Increased AF risk was noted with febuxostat 80 mg/day dose and was most evident in the first 6-months of use. These findings need replication.
E-mail:
Jasvinder.md@gmail.com
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