The effect of xanthine oxidase inhibition upon ejection fraction in heart failure patients: La Plata Study.

CINGOLANI HE; PLASTINO JA; ESCUDERO EM; MANGAL B; BROWN J; PÉREZ NG; CINGOLANI HE; PLASTINO JA; ESCUDERO EM; MANGAL B; BROWN J; P¨¦REZ NG

Boca Raton, Florida

Congreso; 78th Scientific Sessions of The American Heart Association. c; 2005

  Background: Xanthine Oxidase (XO) contributes to oxidative stress in congestive heart failure (CHF). Serum uric acid (SUA) level, a marker of XO activity, can predict clinical outcomes in CHF. We examined whether XO inhibition with oxypurinol may improve cardiac function in patients with CHF. Methods: We performed a randomized, placebo controlled, double blind study on 60 patients (30/group) with New York Heart Association class II-III CHF, comparing 600 mg/day of oxypurinol oral during 4 weeks to placebo, added to standard therapy. All subjects gave written informed consent to participate in the study. Left ventricular ejection fraction (LVEF), SUA level and six-minute walking test were determined before and after treatment. Results: A blinded cardiologist identified a total of 47 patients that satisfy the inclusion criteria of LVEF ≤ 40%. SUA level did not change significantly in the placebo group after treatment (from 76.7 ± 4.2 to 77.7 ± 4.4 mg/L, n=26), while it decreased significantly in the oxypurinol group (from 76.1 ± 5.7 to 60.9 ± 5.0 mg/L, n=21, P<0.01). LVEF before and after treatment was 29.3 ± 1.2 and 30.1 ± 1.6 % (n=26) respectively in the placebo group and 31.5 ± 1.3 and 36.7 ± 2.2 % (n=21) in the oxypurinol group. Adjusting for its basal value (ANCOVA), the LVEF significantly increased in the oxypurinol group relative to placebo by 6.83 ± 2.75 % (P=0.017). No adverse effects attributed to the study medication nor increase in walking capacity was detected after 4 weeks of treatment. Conclusions: Inhibition of XO by oxypurinol in patients with CHF decreases SUA levels and improves LVEF after 4 weeks of oral treatment.