NEW YORK (Reuters) – Men taking allopurinol for gout significantly reduced their risk of nonfatal acute myocardial infarction, according to a new population-based, case-control study. Dr. Francisco de Abajo of the University of Alcala in Madrid, Spain, who was the first author of the study, told Reuters in an email, “Allopurinol has an important cardiovascular protective effect in patients taking it for long-term treatment of gout. This finding supports full compliance with this medication by physicians and patients.” The study, published in the January 5 issue of Heart, reported that allopurinol reduced uric acid formation and oxidized free radical production. A recent study also found that the drug reduced the risk of myocardial infarction, but it was not statistically significant, and the researchers did not analyze the prevalence and incidence of heart attacks. To address the risk of possible bias in case selection, the study led by Dr. de Abajo included only patients who had recently taken allopurinol, excluding those who had already taken the drug at least once before the start of follow-up. They also excluded patients who had had a previous acute heart attack. The study used data from Spanish primary care hospitals and included about 7% of the Spanish population. In total, the investigators included 3,171 patients with nonfatal heart attacks and 18,525 randomly selected healthy controls. Only 0.82% of patients taking allopurinol had an infarction compared to 1.03% of controls, with an OR of 0.52. The finding was concentrated in male patients taking allopurinol, with an OR of 0.44, and in female patients taking allopurinol, with an OR of 0.90, twice as high. The study found that the reduction in risk of heart attack was achieved after patients took at least 300 mg of allopurinol (OR 0.30), and the longer patients took the drug, the greater the reduction in risk of heart attack (p=0.001). In an analysis of patients with previous acute heart attacks, the investigators found an OR of 0.16 for heart attack after allopurinol. The results of this study are not intended to tell patients that they should take allopurinol immediately to reduce the risk of heart disease, but rather to remind patients who take allopurinol according to the drug’s indication that not only is hyperuricemia well controlled and gout prevented, but also that important cardiovascular protective effects, especially in reducing the risk of non-fatal acute heart attacks. de Abajo, MD, noted that allopurinol is by far the basic drug for the long-term treatment of gout. And the drug is very inexpensive. Unfortunately, allopurinol raises the risk of severe hypersensitivity reactions, so its use has been questionable. However, Dr. de Abajo observed that this risk is still relatively low in large populations, and we now know that the drug has additional cardiovascular protection, which greatly offsets the risk of exacerbation of hypersensitivity reactions. de Abajo led the study, which was supported by the Spanish National Ministry of Science and Technology, and one of the authors was also funded by AstraZeneca (UK) and Bayer Pharmaceuticals (Germany).