While gout is considered as a risk factor for vascular diseases, the relation of allopurinol with the risk of cardiovascular events is controversial. In some studies, drug use was associated with an increased vascular risk, while other studies described a protective effect.We conducted a case-control study to examine the relation between allopurinol use and risk of myocardial infarction (MI).Cases (n=2277) were successive patients with a first-ever non-fatal MI referred to 63 cardiology centres throughout France between March 15, 2007 and November 30, 2010. They were matched to 4849 controls selected in a large (12,313) general practice patient referent population. Controls had no past history of coronary heart disease and were matched to MI cases on age, gender, number of visits to a doctor in the preceding year, date of consultation (MI) and past history of high blood pressure. Data about medication use during the two preceding years, and past medical history and life habits (smoking, physical activity, etc.) were obtained from patient's standardized interview and GP records. Odds ratios (OR) and their 95% confidence interval were computed using conditional logistic regression, adjusting for classical vascular risk factors (body mass index, smoking, diabetes, physical activity).MI cases and controls had a mean age of 59 years, 76% were men and 56% reported a history of high blood pressure. High body mass index, low physical activity, smoking and diabetes were more prevalent in cases than in controls. Overall, during the two preceding years, 3.8% of controls and 3.1% of MI cases had used allopurinol, and 1.1 of both cases and controls had used another hypouricemiant. Use of allopurinol was associated with a non-significant decreased risk of MI (adjusted OR (95%CI): 0.75 (0.56 - 1.01).This study showed that allopurinol use is not a risk factor for first-ever non-fatal MI and might rather be associated with a decreased risk of MI.