EFFECT OF ALLOPURINOL TREATMENT ON CARDIAC FUNCTION AND LONG-TERM DISEASE PROGNOSIS IN PATIENTS WITH CHRONIC HEART FAILURE AND HYPERURICEMIA

Abstract

Hyperuricemia (HU) is important and common comorbidity that often coexist in patients with heart failure (HF). High values of serum uric acid are associated to severe heart failure. The purpose of the present study was to evaluate a UA-lowering and prognostic effects of allopurinol in patients with chronic HF and hyperuricemia.We studied 75 patients (50 men and 25 women) with HF and increased UA levels, who have been admitted to hospital since September 2019; All patients aged 18 years and older were eligible, provided a left ventricular ejection fraction of 45% or less was documented on echocardiography during the enrolment visit and signs and symptoms of chronic heart failure were present. Patient baseline assessment included a standardized HF history regarding HF aetiology (classified as ischemic or non-ischemic) and co-morbidities. All patients underwent a standardized clinical evaluation, including physical examination, determination of NYHA class, determination of body weight. Blood samples were drawn from an antecubital vein in the morning for the assessment of a full blood count and clinical chemistry. Echocardiographic parameters included interventricular septum thickness, left ventricular dimension, left ventricular diastolic function, posterior wall thickness, left ventricular mass index, LVEF. Hyperuricemia was defined according to World Health Organization criteria as uric acid level >5.7 mg/dl in women and >7 mg/dl in men. Patients were divided into two groups: 50 patients (group 1) received allopurinol. The initial dose of in most patients was 200 mg/day and it was reduced according to their renal function or UA level. 25 patients (group 2) – controlled group. Treatment duration was 6 and 12 months.Repeated studies after 12 months showed the following results: Uric acid treatment improved the echocardiographic parameters LVEF (38.5± 3.7 and 43.4± 2.4) LV mass index, IVS, PW, stroke volume), reduced NT-proBNP, improved renal function, Improved NYHA functional class; We studied the frequency of cardiovascular events 24-30 months after the start of treatment. Of the 50 patients treated with allopurinol, 11 patients (22%) required rehospitalisation and 9 patients (36%) in the control group;