Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure

Background: 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 arte...

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Main Authors: Manal M Alem, Abdullah M Alshehri, Peter MB Cahusac, Matthew R Walters
Format: Article
Language:English
Published: SAGE Publishing 2018-06-01
Series:Clinical Medicine Insights: Cardiology
Online Access:https://doi.org/10.1177/1179546818779584
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spelling doaj-ba1dc284057448829678685555c752092020-11-25T03:26:31ZengSAGE PublishingClinical Medicine Insights: Cardiology1179-54682018-06-011210.1177/1179546818779584Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart FailureManal M Alem0Abdullah M Alshehri1Peter MB Cahusac2Matthew R Walters3Department of Pharmacology, College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaInternal Medicine Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaDepartment of Comparative Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi ArabiaInstitute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UKBackground: 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. Methods: 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. Results: 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. Conclusions: 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.https://doi.org/10.1177/1179546818779584
collection DOAJ
language English
format Article
sources DOAJ
author Manal M Alem
Abdullah M Alshehri
Peter MB Cahusac
Matthew R Walters
spellingShingle Manal M Alem
Abdullah M Alshehri
Peter MB Cahusac
Matthew R Walters
Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure
Clinical Medicine Insights: Cardiology
author_facet Manal M Alem
Abdullah M Alshehri
Peter MB Cahusac
Matthew R Walters
author_sort Manal M Alem
title Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure
title_short Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure
title_full Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure
title_fullStr Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure
title_full_unstemmed Effect of Xanthine Oxidase Inhibition on Arterial Stiffness in Patients With Chronic Heart Failure
title_sort effect of xanthine oxidase inhibition on arterial stiffness in patients with chronic heart failure
publisher SAGE Publishing
series Clinical Medicine Insights: Cardiology
issn 1179-5468
publishDate 2018-06-01
description Background: 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. Methods: 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. Results: 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. Conclusions: 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.
url https://doi.org/10.1177/1179546818779584
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