Cardiovascular Outcomes of Uric Acid Lowering Medications: A Meta-Analysis.

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Yasser Jamil, Dana Alameddine, Mahmoud El Iskandarani, Ankit Agrawal, Aro D Arockiam, Elio Haroun, Heba Wassif, Patrick Collier, Tom Kai Ming Wang
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引用次数: 0

Abstract

Background: Although hyperuricemia is a recognized risk factor for cardiovascular diseases, mixed results have been reported regarding the associations between uric acid-lowering medications and cardiovascular events. This meta-analysis compared the cardiovascular outcomes of different uric acid-lowering medications and placebo.

Methods: Following PRISMA guidelines, we searched OVID Medline, Embase, Web of Science, and Cochrane databases to identify potentially relevant articles until December 2023. Studies must be randomized or observational, report cardiovascular and mortality outcomes, and compare uric acid-lowering medications to placebo or each other. Data was analyzed using Revman (version 5.4) software.

Results: A total of 3,393 studies were searched, after which 47 studies were included, totaling 3,803,509 patients (28 studies comparing xanthine oxidase inhibitors (XOI) versus placebo, 17 studies comparing allopurinol and febuxostat, and 2 studies comparing XOI and uricosuric agents). Overall mean age was 57.3 years, and females comprised 20.8% of all studies. There were no significant differences between XOI and placebo for cardiovascular outcomes (mortality, myocardial infarction, major adverse cardiovascular events, heart failure, or arrhythmia). There was significant heterogeneity in all these pooled analyses. Comparing Allopurinol to Febuxostat, there was a lower risk of heart failure in febuxostat than allopurinol in 3 RCTs (OR 0.66, 95% CI 0.50-0.89, p = 0.006). Other cardiovascular outcomes were not different. Lastly, when comparing XOI and uricosuric agents, no significant differences in MI rates were evident.

Conclusion: XOI was not associated with reduced cardiovascular events compared to placebo. When comparing XOI agents, Febuxostat might reduce the risk of HF, but future studies are required to confirm the findings from the current study.

降尿酸药物的心血管疗效:一项 Meta 分析
背景:虽然高尿酸血症是心血管疾病的公认风险因素,但有关降尿酸药物与心血管事件之间关系的报道结果不一。这项荟萃分析比较了不同降尿酸药物和安慰剂对心血管的影响:按照 PRISMA 指南,我们检索了 OVID Medline、Embase、Web of Science 和 Cochrane 数据库,以确定 2023 年 12 月之前可能相关的文章。研究必须是随机或观察性的,报告心血管和死亡率结果,并将降尿酸药物与安慰剂或其他药物进行比较。数据使用Revman(5.4版)软件进行分析:共搜索到 3,393 项研究,其中 47 项研究被纳入,共计 3,803,509 名患者(28 项研究比较了黄嘌呤氧化酶抑制剂 (XOI) 与安慰剂,17 项研究比较了别嘌醇与非布司他,2 项研究比较了 XOI 与尿酸盐制剂)。总体平均年龄为 57.3 岁,女性占所有研究的 20.8%。在心血管结果(死亡率、心肌梗死、主要不良心血管事件、心力衰竭或心律失常)方面,XOI 和安慰剂之间没有明显差异。所有这些汇总分析都存在明显的异质性。比较别嘌醇与非布司他,在 3 项研究中,非布司他发生心力衰竭的风险低于别嘌醇(OR 0.66,95% CI 0.50-0.89,P = 0.006)。其他心血管结果没有差异。最后,在比较杏仁酸和尿素类药物时,心肌梗死发生率没有明显差异:结论:与安慰剂相比,XOI 与心血管事件的减少无关。在对XOI药物进行比较时,非布索坦可能会降低心房颤动的风险,但需要今后的研究来证实当前研究的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Cardiology Reports
Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.20
自引率
2.70%
发文量
209
期刊介绍: The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
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