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Hyperuricemia treatment in acute heart failure patients does not improve their long-term prognosis: A propensity score matched analysis from the AHEAD registry
M. Pavlusova, J. Jarkovsky, K. Benesova, J. Vitovec, A. Linhart, P. Widimsky, L. Spinarova, K. Zeman, J. Belohlavek, F. Malek, M. Felsoci, J. Kettner, P. Ostadal, C. Cihalik, J. Spac, H. Al-Hiti, M. Fedorco, R. Fojt, A. Kruger, J. Malek, T....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
Grantová podpora
MUNI/A/1250/2017
Masaryk University, Brno
65269705
Ministry of Health of the Czech Republic
NLK
Directory of Open Access Journals
od 2019
PubMed Central
od 1997
Europe PubMed Central
od 1997
ProQuest Central
od 2019-01-01
Health & Medicine (ProQuest)
od 2019-01-01
Wiley-Blackwell Open Access Titles
od 1978
PubMed
31119751
DOI
10.1002/clc.23197
Knihovny.cz E-zdroje
- MeSH
- akutní nemoc MeSH
- alopurinol aplikace a dávkování MeSH
- antiuratika aplikace a dávkování MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- hyperurikemie krev komplikace farmakoterapie MeSH
- kyselina močová krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- následné studie MeSH
- příčina smrti MeSH
- prognóza MeSH
- prospektivní studie MeSH
- registrace * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdeční selhání komplikace mortalita MeSH
- tendenční skóre * MeSH
- výsledek terapie MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Hyperuricemia is associated with a poorer prognosis in heart failure (HF) patients. Benefits of hyperuricemia treatment with allopurinol have not yet been confirmed in clinical practice. The aim of our work was to assess the benefit of allopurinol treatment in a large cohort of HF patients. METHODS: The prospective acute heart failure registry (AHEAD) was used to select 3160 hospitalized patients with a known level of uric acid (UA) who were discharged in a stable condition. Hyperuricemia was defined as UA ≥500 μmoL/L and/or allopurinol treatment at admission. The patients were classified into three groups: without hyperuricemia, with treated hyperuricemia, and with untreated hyperuricemia at discharge. Two- and five-year all-cause mortality were defined as endpoints. Patients without hyperuricemia, unlike those with hyperuricemia, had a higher left ventricular ejection fraction, a better renal function, and higher hemoglobin levels, had less frequently diabetes mellitus and atrial fibrillation, and showed better tolerance to treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and/or beta-blockers. RESULTS: In a primary analysis, the patients without hyperuricemia had the highest survival rate. After using the propensity score to set up comparable groups, the patients without hyperuricemia had a similar 5-year survival rate as those with untreated hyperuricemia (42.0% vs 39.7%, P = 0.362) whereas those with treated hyperuricemia had a poorer prognosis (32.4% survival rate, P = 0.006 vs non-hyperuricemia group and P = 0.073 vs untreated group). CONCLUSION: Hyperuricemia was associated with an unfavorable cardiovascular risk profile in HF patients. Treatment with low doses of allopurinol did not improve the prognosis of HF patients.
Department of Cardiology Hospital Na Homolce Prague Czech Republic
Department of Cardiology Institute of Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology Tomas Bata Regional Hospital Zlin Czech Republic
Department of Internal Medicine Hospital Frydek Mistek Frydek Mistek Czech Republic
Department of Internal Medicine Hospital Havlickuv Brod Havlickuv Brod Czech Republic
Department of Internal Medicine Hospital Znojmo Znojmo Czech Republic
Department of Internal Medicine University Hospital Olomouc Olomouc Czech Republic
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic
Citace poskytuje Crossref.org
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- $a Pavlusova, Marie $u Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic. Faculty of Medicine, Masaryk University, Brno, Czech Republic.
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- $a BACKGROUND: Hyperuricemia is associated with a poorer prognosis in heart failure (HF) patients. Benefits of hyperuricemia treatment with allopurinol have not yet been confirmed in clinical practice. The aim of our work was to assess the benefit of allopurinol treatment in a large cohort of HF patients. METHODS: The prospective acute heart failure registry (AHEAD) was used to select 3160 hospitalized patients with a known level of uric acid (UA) who were discharged in a stable condition. Hyperuricemia was defined as UA ≥500 μmoL/L and/or allopurinol treatment at admission. The patients were classified into three groups: without hyperuricemia, with treated hyperuricemia, and with untreated hyperuricemia at discharge. Two- and five-year all-cause mortality were defined as endpoints. Patients without hyperuricemia, unlike those with hyperuricemia, had a higher left ventricular ejection fraction, a better renal function, and higher hemoglobin levels, had less frequently diabetes mellitus and atrial fibrillation, and showed better tolerance to treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and/or beta-blockers. RESULTS: In a primary analysis, the patients without hyperuricemia had the highest survival rate. After using the propensity score to set up comparable groups, the patients without hyperuricemia had a similar 5-year survival rate as those with untreated hyperuricemia (42.0% vs 39.7%, P = 0.362) whereas those with treated hyperuricemia had a poorer prognosis (32.4% survival rate, P = 0.006 vs non-hyperuricemia group and P = 0.073 vs untreated group). CONCLUSION: Hyperuricemia was associated with an unfavorable cardiovascular risk profile in HF patients. Treatment with low doses of allopurinol did not improve the prognosis of HF patients.
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