Effect of Uric Acid-Lowering Agents on Cardiovascular Outcome in Patients With Heart Failure: A Systematic Review and Meta-Analysis of Clinical Studies.

Journal Article (Journal Article;Systematic Review)

Several trials have been completed in patients with heart failure (HF) treated with uric acid (UA)-lowering agents with inconsistent results. We aimed to investigate whether lowering UA would have an effect on mortality and cardiovascular (CV) events in patients with HF in a systematic review and meta-analysis. The primary outcome measures were all-cause mortality, CV mortality, CV events, and CV hospitalization in patients with HF. We included 11 studies in our final analysis. Overall, allopurinol treatment was associated with a significant increase in the risk for all-cause mortality (hazard ratio [HR]: 1.24, 95% confidence interval [CI]: 1.04-1.49, P = .02). The trial heterogeneity is high (heterogeneity χ2 = 37.3, I2 = 73%, P < .001). With regard to CV mortality, allopurinol treatment was associated with a 42% increased risk of CV mortality (HR: 1.42, 95% CI: 1.11-1.81, P = .005). There was a trend toward increased CV hospitalization in the same group (HR: 1.21, 95% CI: 0.95-1.53, P = .12). Uric acid-lowering treatments increase all-cause and CV mortality but did not increase CV hospitalization significantly in this study.

Full Text

Duke Authors

Cited Authors

  • Kanbay, M; Afsar, B; Siriopol, D; Dincer, N; Erden, N; Yilmaz, O; Sag, AA; Kuwabara, M; Cherney, D; Rossignol, P; Ortiz, A; Covic, A

Published Date

  • April 2020

Published In

Volume / Issue

  • 71 / 4

Start / End Page

  • 315 - 323

PubMed ID

  • 32000517

Electronic International Standard Serial Number (EISSN)

  • 1940-1574

Digital Object Identifier (DOI)

  • 10.1177/0003319719897509


  • eng

Conference Location

  • United States