Table 4.
Incidence and hazard ratio of stroke between cohorts receiving or not receiving urate-lowering therapy.
| Urate-lowering therapy | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| No | Yes | ||||||||
| Event | PY | IR | Event | PY | IR | cHR (95%CI) | aHR (95%CI) | ||
| Overall | 100 | 9,137 | 1.1 | 78 | 9,657 | 0.8 | 0.73 (0.55, 0.99)* | 0.68 (0.5, 0.92)* | |
| XO inhibitors | 100 | 9,137 | 1.1 | 27 | 2,873 | 0.9 | 0.86 (0.56, 1.31) | 0.76 (0.49, 1.18) | |
| Uricosuric agents | 100 | 9,137 | 1.1 | 51 | 6,785 | 0.8 | 0.68 (0.49, 0.96)* | 0.65 (0.46, 0.91)* | |
| SEX | |||||||||
| Female | 20 | 1,767 | 1.1 | 26 | 1,802 | 1.4 | 1.26 (0.71, 2.26) | 0.64 (0.33, 1.26) | |
| Male | 80 | 7,370 | 1.1 | 52 | 7,855 | 0.7 | 0.61 (0.43, 0.86)** | 0.64 (0.45, 0.91)* | |
| AGE, YEARS | |||||||||
| 20–39 | 10 | 3,720 | 0.3 | 9 | 4,000 | 0.2 | 0.83 (0.34, 2.04) | 1.08 (0.39, 3.04) | |
| 40–59 | 48 | 4,147 | 1.2 | 33 | 4,147 | 0.8 | 0.68 (0.44, 1.06) | 0.62 (0.39, 0.97)* | |
| 60–79 | 42 | 1,270 | 3.3 | 36 | 1,510 | 2.4 | 0.7 (0.45, 1.1) | 0.7 (0.43, 1.13) | |
| COMORBIDITY | |||||||||
| Hypertension | No | 49 | 7,443 | 0.7 | 43 | 7,770 | 0.6 | 0.84 (0.56, 1.26) | 0.86 (0.56, 1.3) |
| Yes | 51 | 1,693 | 3.0 | 35 | 1,887 | 1.9 | 0.59 (0.39, 0.91)* | 0.48 (0.3, 0.77)** | |
| DM | No | 82 | 8,589 | 1.0 | 66 | 9,110 | 0.7 | 0.76 (0.55, 1.04) | 0.72 (0.52, 1.01) |
| Yes | 18 | 548 | 3.3 | 12 | 547 | 2.2 | 0.68 (0.33, 1.42) | 0.43 (0.18, 1.01) | |
| Hypercholesterolemia | No | 66 | 7,361 | 0.9 | 51 | 7,730 | 0.7 | 0.73 (0.51, 1.06) | 0.68 (0.47, 0.99)* |
| Yes | 34 | 1,776 | 1.9 | 27 | 1,927 | 1.4 | 0.68 (0.41, 1.13) | 0.64 (0.37, 1.1) | |
| Peripheral vascular diseases | No | 94 | 9,002 | 1.0 | 74 | 9,528 | 0.8 | 0.74 (0.55, 1) | 0.68 (0.5, 0.93)* |
| Yes | 6 | 135 | 4.5 | 4 | 129 | 3.1 | 0.66 (0.19, 2.38) | ||
| Atrial fibrillation | No | 100 | 9,125 | 1.1 | 77 | 9,651 | 0.8 | 0.72 (0.54, 0.97)* | 0.67 (0.49, 0.91)** |
| Yes | 0 | 12 | 0 | 1 | 7 | 15 | |||
| Rheumatologic diseases | No | 98 | 8,937 | 1.1 | 77 | 9,424 | 0.8 | 0.74 (0.55, 1)* | 0.69 (0.51, 0.94)* |
| Yes | 2 | 200 | 1.0 | 1 | 233 | 0.4 | 0.42 (0.04, 4.66) | ||
| Renal diseases | No | 97 | 8,991 | 1.1 | 76 | 9,454 | 0.8 | 0.74 (0.55, 1) | 0.7 (0.51, 0.95)* |
| Yes | 3 | 146 | 2.1 | 2 | 203 | 1.0 | 0.48 (0.08, 2.87) | ||
| Alcohol-related diseases | No | 94 | 8,937 | 1.1 | 74 | 9,390 | 0.8 | 0.74 (0.55, 1.01) | 0.7 (0.52, 0.96)* |
| Yes | 6 | 199 | 3.0 | 4 | 267 | 1.5 | 0.5 (0.14, 1.78) | 0.12 (0.02, 0.88)* | |
| DRUG | |||||||||
| ACE inhibitors/ARBs | No | 70 | 8,295 | 0.8 | 60 | 8,605 | 0.7 | 0.82 (0.58, 1.16) | 0.85 (0.6, 1.21) |
| Yes | 30 | 841 | 3.6 | 18 | 1052 | 1.7 | 0.47 (0.26, 0.85)* | 0.25 (0.13, 0.49)*** | |
| β-blockers | No | 56 | 7,260 | 0.8 | 48 | 7,519 | 0.6 | 0.82 (0.56, 1.21) | 0.84 (0.56, 1.24) |
| Yes | 44 | 1,877 | 2.3 | 30 | 2,138 | 1.4 | 0.59 (0.37, 0.94)* | 0.41 (0.25, 0.69)*** | |
| Calcium-channel blockers | No | 54 | 7,808 | 0.7 | 54 | 8,144 | 0.7 | 0.96 (0.66, 1.4) | 1.02 (0.69, 1.5) |
| Yes | 46 | 1,329 | 3.5 | 24 | 1,514 | 1.6 | 0.44 (0.27, 0.72)** | 0.34 (0.2, 0.58)*** | |
| Diuretics | No | 70 | 7,886 | 0.9 | 52 | 8,057 | 0.7 | 0.73 (0.51, 1.04) | 0.71 (0.49, 1.02) |
| Yes | 30 | 1,251 | 2.4 | 26 | 1,601 | 1.6 | 0.69 (0.41, 1.18) | 0.55 (0.31, 0.96)* | |
| Potassium sparing diuretics | No | 100 | 9,053 | 1.1 | 75 | 9,521 | 0.8 | 0.71 (0.53, 0.96)* | 0.66 (0.48, 0.89)** |
| Yes | 0 | 84 | 0.0 | 3 | 136 | 2.2 | |||
| Metformin | No | 90 | 8,852 | 1.0 | 71 | 9,347 | 0.8 | 0.74 (0.55, 1.02) | 0.7 (0.51, 0.96)* |
| Yes | 10 | 285 | 3.5 | 7 | 311 | 2.3 | 0.58 (0.21, 1.59) | 0.46 (0.13, 1.62) | |
| sulfonylurea | No | 92 | 8,805 | 1.0 | 71 | 9,289 | 0.8 | 0.73 (0.53, 0.99)* | 0.68 (0.5, 0.94)* |
| Yes | 8 | 331 | 2.4 | 7 | 369 | 1.9 | 0.86 (0.31, 2.37) | 0.56 (0.15, 2.05) | |
| Insulin | No | 98 | 9,038 | 1.1 | 76 | 9,584 | 0.8 | 0.73 (0.54, 0.98)* | 0.66 (0.49, 0.9)** |
| Yes | 2 | 98 | 2.0 | 2 | 73 | 2.7 | 1.22 (0.17, 8.69) | ||
| Statin | No | 92 | 8,802 | 1.0 | 72 | 9,215 | 0.8 | 0.74 (0.55, 1.01) | 0.71 (0.52, 0.98)* |
| Yes | 8 | 334 | 2.4 | 6 | 442 | 1.4 | 0.5 (0.17, 1.46) | 0.14 (0.03, 0.69)* | |
| Aspirin | No | 86 | 8,502 | 1.0 | 69 | 8,919 | 0.8 | 0.76 (0.55, 1.04) | 0.71 (0.52, 0.99)* |
| Yes | 14 | 635 | 2.2 | 9 | 738 | 1.2 | 0.55 (0.24, 1.27) | 0.43 (0.16, 1.19) | |
IR, incidence rate, per 100 person-years; PY, person-years; CI, confidence interval; cHR, crude hazard ratio; aHR, adjusted hazard ratio, controlling for sex, age, area, every comorbidity, and drug in Table 1; XO inhibitors, xanthine oxidase inhibitors, consisting of allopurinol, and febuxostat; Uricosuric agents, consisting of benzbromarone, probenecid, and sulfinpyrazone; ACE inhibitors, angiotensin-converting enzyme inhibitors.
ARBs, angiotensin II receptor blockers;
*
P < 0.05,
**
P < 0.01, and
***
P < 0.001.