<p>Effect of Long-Term Allopurinol Therapy on Left Ventricular Mass Index in Patients with Ischemic Heart Disease; A Cross-Sectional Study</p>

Abstract

BackgroundLeft ventricular hypertrophy (LVH), as assessed by measurement of left ventricular mass (LVM), is one of the most important cardiovascular risk factors. It is commonly present in patients with ischemic heart disease (IHD), irrespective of the level of blood pressure; recently, oxidative stress has been shown to be an important factor in its development. The question then arises: can this risk factor be modified by antioxidant treatment (e.g., with allopurinol, a xanthine oxidase inhibitor)?MethodsThis is an observational study with a cross-sectional design which explored the association between long-term (>12 months) allopurinol therapy and LV mass index (LVMI) as well as geometry in patients generally receiving standard treatments for IHD. The primary endpoint was LVMI measurement (by 2D-echocardiography) and secondary endpoints included the association of allopurinol use with LV function (ejection fraction), blood pressure, glycemic control, and lipid profile.ResultsNinety-six patients on standard anti-ischemic drug treatment (control group) and 96 patients who were additionally taking allopurinol (minimum dose 100 mg/day) were enrolled. Both groups were matched for age, sex, height, and co-morbidities, but poorer kidney function in the allopurinol group required further sub-group analysis based on renal function. Allopurinol treatment was associated with the lowest LVMI in the patients with normal serum creatinine (median LVMI; 70.5 g/m2): corresponding values were 76.0 and 87.0 in the control group with, respectively, normal and elevated serum creatinine, and 89.5 in the allopurinol group with elevated serum creatinine (P=0.027). In addition, allopurinol was associated with better glycemic control (HbA1c) with a difference of 0.8% (95% CI; 1.3, 0.2) (P=0.004) as compared with control patients.ConclusionIn our population, treatment with allopurinol (presumably because of its anti-oxidant properties) has shown a tendency to be associated with smaller LVM in IHD patients with normal serum creatinine, along with better glycemic control.

Effect of low dose allopurinol on glycemic control and glycemic variability in patients with type 2 diabetes mellitus: A cross-sectional study

“…These comorbidities, along with beta-blockers and diuretics, are known to have negative effects on glucose homeostasis [ 32 ], raising the possibility of an otherwise greater beneficial effect from allopurinol. In that regard, the magnitude of drop in HbA1c in this study was smaller than was observed in another sample of our population in a previous study of similar sample size, allopurinol dose and duration (−0.8% reduction) [ 22 ].…”

“…Using previous results [ 22 ], and assuming a pooled standard deviation of 2.05 units, the study would require a sample size of 89 patients in each group (a total sample size of 178 patients) to achieve a 90% power and a level of significance of 5% (two-sided), to detect a true difference of 1% in glycated hemoglobin means between allopurinol users, and control subjects.…”

Clinical, Echocardiographic, and Therapeutic Characteristics of Heart Failure in Patients with Preserved, Mid-Range, and Reduced Ejection Fraction: Future Directions

“…Recruitment of eligible patients in both studies was described elsewhere. 10 , 11 The variables collected were: patient’s demographic information, NYHA functional class, etiology of heart failure, and co-morbidities (systemic hypertension, diabetes mellitus (DM), dyslipidemia, arrhythmias (including atrial fibrillation (AF)), transient ischemic attacks (TIA), and stroke. Patients’ cardiac medications, anti-diabetic drugs and other relevant drugs were also documented.…”

Low dose allopurinol is associated with modest but significant improvements in glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes mellitus: A cross-sectional study

“…Using our previous results (22), and assuming a pooled standard deviation of 2.05 units, the study would require a sample size of 89 patients in each group (a total sample size of 178 patients) to achieve a 90% power and a level of signi cance of 5% (two-sided), to detect a true difference of 1% in glycated hemoglobin means between allopurinol users, and control subjects.…”