LAUSR

The role of urate-lowering therapy (ULT) for the primary prevention of cardiovascular events has been widely discussed, but its evidence for the secondary prevention of myocardial infarction (MI) is limited. Therefore, we conduct a population-based, propensity score-matched cohort study to investigate the cardiovascular outcomes among post-MI patients with and without ULT. A total of 19,042 newly diagnosed in-hospital MI patients were selected using the Taiwan National Health Insurance Database between 1 January 2005 and 31 December 2016. After 1:1 propensity score matching with covariates, MI patients with (n=963) and without (n=963) ULT were selected for further analysis. The primary outcome was the all-cause mortality and the secondary outcomes were composite cardiovascular (CV) outcomes, including hospitalization for recurrent MI, stroke, heart failure, and cardiac arrhythmias. ULT users were associated with lower all-cause mortality (adjusted hazard ratio [adjHR], 0.67; 95% confidence interval [CI], 0.51-0.87) compared to the ULT nonusers. In addition, ULT users had a significantly lower risk of recurrent MI which needed revascularization by percutaneous coronary intervention or coronary artery bypass grafting (adjHR, 0.67; 95% CI, 0.53-0.86) than the ULT nonusers. The primary and secondary outcomes were not different between post-MI patients who received uricosuric agents and xanthine oxidase inhibitors. The anti-inflammatory effect of ULT plays an essential role in MI management. From a real-world setting, this study shows that ULT is associated with the lower risk of all-cause mortality in post-MI patients. In addition, the result shows the possible lower incidence of repeat revascularization procedures in the ULT users.