Effect of xanthine oxidase inhibition on arterial stiffness in patients with chronic heart failure

Alem, M. M., Alshehri, A. M., Cahusac, P. M.B. and Walters, M. R. (2018) Effect of xanthine oxidase inhibition on arterial stiffness in patients with chronic heart failure. Clinical Medicine Insights: Cardiology, 12, pp. 1-10. (doi: 10.1177/1179546818779584) (PMID:29899669) (PMCID:PMC5992797)

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The xanthine oxidase inhibitor allopurinol improves endothelial function in different populations, including patients with chronic heart failure (CHF). Its effect on arterial stiffness parameters is less clear. We investigated the effect of short-term low-dose allopurinol therapy on arterial stiffness in Saudi patients with stable mild-moderate CHF.A prospective, randomized, double-blind, placebo-controlled study was performed on 73 patients with mild-moderate CHF. In all, 36 patients were randomized to allopurinol 300 mg daily for 3 months, while 37 patients were randomized to placebo. Arterial stiffness parameters, aortic pulse wave velocity (Ao-PWV) and heart rate corrected augmentation index (c-AIx), were assessed before and after treatment along with serum uric acid.A total of 66 patients completed the study. Both groups were matched for age, sex, severity of heart failure, and arterial stiffness. Compared with placebo, allopurinol recipients had a significant fall in uric acid concentration from 6.31 ± 1.4 (SD) mg/dL to 3.81 ± 1.2 (P < .001). Despite that, there was no significant change in arterial stiffness parameters between allopurinol and placebo groups. Post-treatment Ao-PWV was 9.79 ± 2.6 m/s in the allopurinol group and 10.07 ± 3.4 m/s in the placebo group, P = .723. Post-treatment c-AIx was 24.0% ± 9.1% and 22.0% ± 9.9%, respectively, P = .403.We have shown that allopurinol significantly reduced uric acid concentration in Saudi patients with CHF but was not associated with a change in arterial stiffness. Our cohort of patients had worse arterial stiffness values at baseline, which might make them more resistant to change using our study regimen.The study has been registered with the International Standard Randomized Controlled Trial Number registry with an identifier number of ISRCTN58980230.

Item Type:Articles
Keywords:This clinical trial was funded by deanship of scientific research at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (grant 20100065).
Glasgow Author(s) Enlighten ID:Walters, Professor Matthew
Authors: Alem, M. M., Alshehri, A. M., Cahusac, P. M.B., and Walters, M. R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Clinical Medicine Insights: Cardiology
Publisher:Libertas Academica
ISSN (Online):1179-5468
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Clinical Medicine Insights: Cardiology 12:1-20
Publisher Policy:Reproduced under a Creative Commons License

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