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High-dose allopurinol reduces left ventricular mass in patients with ischemic heart disease

Sushma Rekhraj1, Stephen J Gandy, Benjamin R Szwejkowski

  • 1Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom.

Journal of the American College of Cardiology
|March 2, 2013
PubMed

Insights

High-dose allopurinol significantly reduced left ventricular mass (LVM) and improved endothelial function in patients with ischemic heart disease (IHD). This suggests allopurinol may decrease cardiovascular events and mortality in this population.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Left ventricular hypertrophy (LVH) is prevalent in ischemic heart disease (IHD) patients, even those with normal blood pressure.
  • Allopurinol, a xanthine oxidase inhibitor, may regress LVH by reducing left ventricular (LV) afterload.

Purpose of the Study:

  • To determine if high-dose allopurinol can reduce left ventricular mass (LVM) in patients with IHD.
  • To investigate allopurinol's effects on LV volumes, endothelial function, and arterial stiffness.

Main Methods:

  • A 9-month, randomized, double-blind, placebo-controlled study involving 66 IHD patients with LVH.
  • Allopurinol (600 mg/day) or placebo was administered, with LVM assessed by cardiac magnetic resonance imaging (CMR).
  • Secondary outcomes included LV volumes, flow-mediated dilation (FMD), and arterial stiffness.

Main Results:

  • Allopurinol significantly reduced LVM and left ventricular mass index (LVMI) compared to placebo (p=0.007 and p=0.023, respectively).
  • Allopurinol also decreased LV end-systolic volume (p=0.047) and improved FMD (p=0.017) and augmentation index (p=0.02).

Conclusions:

  • High-dose allopurinol effectively regresses LVH and improves vascular function in IHD patients.
  • These findings suggest a potential role for allopurinol in reducing future cardiovascular events and mortality.
Abstract

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