Hyperuricaemia and vascular risk

Landolfo, Matteo; Borghi, Claudio

doi:10.1097/hco.0000000000000626

Cited by 18 publications

(15 citation statements)

References 60 publications

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“…Hyperuricemia is a well-known risk factor of CVD and elevated oxidative stress is the main upstream mechanism in the pathophysiology of CVD risk derived from high serum UA levels (e.g. endothelial dysfunction, increased inflammation and insulin resistance) [53]. Therefore, the pro-oxidant conversion concentration of UA may be approximately 6-7 mg/dl.…”

Section: Discussionmentioning

confidence: 99%

Sex‐specific association of urate and levodopa‐induced dyskinesia in Parkinson’s disease

Jung

Chung

Yoo

et al. 2020

Euro J of Neurology

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Background and purpose As a major antioxidant, uric acid (UA) is known to be associated with the clinical progression of Parkinson’s disease (PD). This study investigated whether baseline UA levels are associated with the risk for levodopa‐induced dyskinesia (LID) in PD in a sex‐dependent manner. Methods In all, 152 patients with de novo PD (78 males and 74 females) who were followed up for >2 years were enrolled. The effect of baseline serum UA levels on LID‐free survival was assessed by Cox regression, separately for sex, whilst being adjusted for potential confounding factors. The optimal UA level cut‐off value to determine the high‐risk group for LID was set using Contal and O’Quigley’s method. Results Levodopa‐induced dyskinesia developed in 23 (29.5%) male patients and 30 (40.5%) female patients. Cox regression showed a significant interaction between UA level and sex. Higher UA levels were associated with a higher risk for LID in male PD patients (hazard ratio 1.380; 95% confidence interval 1.038–1.835; P = 0.027), although this relationship was not observed in female PD patients. The optimal UA level cut‐off for LID in male PD was 7.2 mg/dl, and the high UA group had a 5.7‐fold higher risk of developing LID than the low UA group. Conclusions Contrary to a presumptive beneficial role of UA, the present study demonstrated that higher UA levels are associated with increased risk of LID occurrence in male patients with PD, suggesting a sex‐dependent role of UA in LID.

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Section: Discussionmentioning

confidence: 99%

Sex‐specific association of urate and levodopa‐induced dyskinesia in Parkinson’s disease

Jung

Chung

Yoo

et al. 2020

Euro J of Neurology

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“…Mounting evidence shows that hyperuricemia and gout are associated with an increased risk of cardiovascular disease [1][2][3][4], suggesting that they are important risk factors, though a reverse causality 2 of 15 cannot be ruled out [5]. In this context, it is of interest to know whether urate-lowering therapy (ULT) reduces the risk of cardiovascular events in hyperuricemic patients.…”

Section: Introductionmentioning

confidence: 99%

“…In 2015, our group reported a risk reduction of acute myocardial infarction (AMI), which was dose-and duration-dependent, among allopurinol initiators [11], but recent studies yielded conflicting results, with some reporting a protective effect [12][13][14][15] and others no effect [16][17][18] or an increased risk [19]. Thus, the subject is still a matter of controversy and further studies are needed [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Another important issue still unsolved is whether the potential protective effect of allopurinol on AMI is related or not with the lowering of serum uric acid (SUA) levels [1,2,20]. Previous studies either did not address the issue [12,14] or did not find a relation [11,13,15,16], although the sample size could have been a limitation to draw a firm conclusion.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Acute Myocardial Infarction Among New Users of Allopurinol According to Serum Urate Level: A Nested Case-Control Study

Rodríguez‐Martín

Abajo

Gil

et al. 2019

JCM

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Objectives: To test the hypothesis that allopurinol reduces the risk of acute myocardial infarction (AMI) in hyperuricemic patients and to assess whether the effect is dependent on dose, duration and serum uric acid (SUA) level attained after treatment. Methods: Nested case-control study over the period 2002-2015. From a cohort of patients aged 40-99 years old, we identified incident AMI cases and randomly selected five controls per case, matched for exact age, sex and index date. Adjusted odds ratios (AOR) and 95% CI were computed through unconditional logistic regression. Only new users of allopurinol were considered. Results: A total of 4697 AMI cases and 18,919 controls were included. Allopurinol use was associated with a reduced risk of AMI mainly driven by duration of treatment (AOR ≥180 days = 0.71; 95% CI: 0.60-0.84). Among long-term users (≥180 days), the reduced risk was only observed when the SUA level attained was below 7 mg/dL (AOR <6 mg/dL = 0.64; 95% CI: 0.49-0.82; AOR 6-7mg/dL = 0.64; 95%CI:0.48-0.84); AOR >7mg/dL = 1.04; 95% CI: 0.75-1.46; p for trend = 0.001). A dose-effect was observed but faded out once adjusted for the SUA level attained. The reduced risk of AMI occurred in both patients with gout and patients with asymptomatic hyperuricemia. Conclusions: The results confirm a cardioprotective effect of allopurinol which is strongly dependent on duration and SUA level attained after treatment.

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“…Хотя ассоциация ГУ с ССЗ давно известна [9], возможность применения для лечения таких пациентов препаратов, снижающих уровень мочевой кислоты (МК), стала рассматриваться только в последние годы, после появления крупных наблюдательных исследований, доказывающих, что ГУ независимо от других факторов риска коррелирует с развитием как ССЗ в целом, так и непосредственно с СН [10][11][12][13].…”

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Urate-lowering therapy for heart failure

Желябина¹,

Елисеев²

2019

Sovremennaâ revmatologiâ

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Сердечная недостаточность (СН) связана с высоким риском смерти и значительными финансовыми потерями, обусловленными в том числе необходимостью частой госпитализации в отделения неотложной помощи и палаты интенсивной терапии. СН характеризуется выраженным, прогрессирующим ухудшением качества жизни в результате снижения трудоспособности и толерантности к минимальной физической нагрузке [1-2]. Это одна из основных проблем общественного здравоохранения развитых стран: ежегодно СН диагностируется более чем у 550 тыс. человек, она выявлена у 5,8 млн жителей США. По данным ВОЗ, в мире насчитывается не менее 23 млн больных СН, более 1 млн из них госпитализируют в течение календарного года. СН является непосредственной причиной более 7% всех сердечно-сосудистых смертей [3, 4]. В отличие от других форм сердечно-сосудистых заболеваний (ССЗ), в частности ишемической болезни сердца (ИБС) и острого нарушения мозгового кровообращения, в лечении которых в последние десятилетия достигнуты серьезные успехи, распространенность, заболеваемость СН и смертность от нее в последние несколько десятилетий не только не снижаются, но и возрастают, и прогноз остается крайне неблагоприятным [5, 6]. Показатели смертности при СН столь высоки, что превосходят таковые при онкологических заболеваниях: более 40% пациентов умирают в течение года после первой госпитализации [7]. Среди факторов риска, непосредственно влияющих на развитие, тяжесть течения, прогрессирование и исходы СН, выделяют традиционные, необходимость коррекции которых не вызывает сомнений: артериальная гипертензия, нарушения сердечного ритма, кардиомиопатии, сахарный диабет (СД), гиперхолестеринемия и дислипидемия, курение, злоупотребление алкоголем, а также нетрадиционные, влияние которых на риск развития ССЗ и их исходы стало активно обсуждаться относительно недавно: хроническое воспаление, гиперурикемия (ГУ), дефицит витамина D. Изучение фармакологических методов коррекции нетрадиционных факторов риска может стать перспективным направлением терапии СН. Одной из мишеней такой терапии пред

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Hyperuricaemia and vascular risk

Cited by 18 publications

References 60 publications

Sex‐specific association of urate and levodopa‐induced dyskinesia in Parkinson’s disease

Sex‐specific association of urate and levodopa‐induced dyskinesia in Parkinson’s disease

Risk of Acute Myocardial Infarction Among New Users of Allopurinol According to Serum Urate Level: A Nested Case-Control Study

Urate-lowering therapy for heart failure

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