European Heart Journal — Cardiovascular Pharmacotherapy最新文献

{"title":"Thromboprophylaxis for COVID-19-related coagulopathy: what next?","authors":"Viktor Čulić, Riccardo Vio, Riccardo Proietti","doi":"10.1093/ehjcvp/pvac009","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvac009","url":null,"abstract":"Patients hospitalized with coronavirus disease 2019 (COVID-19) are at high risk for microand macrovascular thromboembolic events due to thromboinflammation and the coagulopathy caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).1,2 Because of its proven anticoagulation effect, coupled with possible antiviral and anti-inflammatory effects, heparin was the first candidate for prevention of adverse events in COVID-19 patients.2 Yet, a recent meta-analysis of seven clinical trials using low-molecular-weight heparin (LMWH) or unfractionated heparin suggests no difference in all-cause death between the therapeutic-, i.e. escalated, and standard-dose anticoagulation in hospitalized COVID-19 patients without a formal indication for anticoagulation therapy.3 The escalated dose significantly reduced the rates of pulmonary and other venous thromboembolism, but was associated with a higher bleeding risk.3 The findings were consistent with regard to the disease severity (critically vs. non-critically ill COVID-19 patients).3 It is important to note that the aforementioned meta-analyis3 did not include the most recent HEP-COVID trial,4 the first randomized trial using a classic antithrombotic clinical trial design. This trial, similarly to another important report by the REMAP-CAP, ACTIV4a, and ATTACC Investigators,5 suggests that therapeutic-dose LMWH reduced the risk of thromboembolism and death in non-critically ill patients. These two well-designed studies strongly suggest the use of escalated anticoagulation in this group of hospitalized patients, particularly with elevated D-dimer levels. In contrast, current data agree that escalation of heparin dose in critically ill COVID-19 patients requiring intensive care unit treatment provides no benefit,3,4,6 so the anticoagulation strategy in such patients is uncertain. In addition to coagulopathy, hyperinflammation, and endothelial disruption, mechanisms responsible for the lack of a beneficial effect in critically ill patients may include lung-related mechanisms. First, therapeutic-dose anticoagulation may exacerbate alveolar haemorrhage in patients with severe pulmonary inflammation.6 Second, the processes of intra-alveolar coagulation that through isolation of pulmonary pathogens may","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"E18-E19"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9383404/pdf/pvac009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39576021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-renal benefits of sodium-glucose co-transporter 2 inhibitors in heart failure with reduced ejection fraction: mechanisms and clinical evidence.","authors":"Jose S Aguilar-Gallardo,&nbsp;Ashish Correa,&nbsp;Johanna P Contreras","doi":"10.1093/ehjcvp/pvab056","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvab056","url":null,"abstract":"<p><p>The heart and the kidneys are closely interconnected, and disease in one organ system can lead to disease in the other. This interdependence is illustrated in heart failure with reduced ejection fraction (HFrEF), where worsening heart failure (HF) can lead to renal dysfunction and vice versa. Further complicating this situation is the fact that drugs that serve as guideline-directed medical therapy for HFrEF can affect renal function. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of medication with an evolving role in HF and chronic kidney disease (CKD). Initially found to have benefits in diabetic patients, new research established potential cardiovascular and renal benefits in patients with HF independent of their diabetic status and in populations with CKD. This has been established by landmark trials such as EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients with Chronic Heart Failure and a Reduced Ejection Fraction), EMPA-TROPISM (Are the 'Cardiac Benefits' of Empagliflozin Independent of Its Hypoglycemic Activity), CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation), DAPA-CKD (Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease), DAPA-HF (Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure), and DEFINE-HF (Dapagliflozin Effects on Biomarkers, Symptoms and Functional Status in Patients with HF with Reduced Ejection Fraction). Multiple mechanisms responsible for these benefits have been suggested by clinical and non-clinical studies, and involve cardiac and renal energetic efficiency, cardiac remodelling, preservation of renal function, immunomodulation, changes in haematocrit, and control of risk factors. As such, SGLT2 inhibitors have tremendous potential to improve outcomes in populations with HF and CKD. The purpose of this review is to discuss the current evidence and underlying mechanisms for the cardio-renal benefits of SGLT2 inhibitors in patients with HFrEF.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"311-321"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity of diabetes as a risk factor for major adverse cardiovascular events in anticoagulated patients with atrial fibrillation: an analysis of the ARISTOTLE trial.","authors":"Raffaele De Caterina,&nbsp;Giuseppe Patti,&nbsp;Johan Westerbergh,&nbsp;John Horowitz,&nbsp;Justin A Ezekowitz,&nbsp;Basil S Lewis,&nbsp;Renato D Lopes,&nbsp;John J V McMurray,&nbsp;Dan Atar,&nbsp;M Cecilia Bahit,&nbsp;Matyas Keltai,&nbsp;José L López-Sendón,&nbsp;Witold Ruzyllo,&nbsp;Christopher B Granger,&nbsp;John H Alexander,&nbsp;Lars Wallentin","doi":"10.1093/ehjcvp/pvaa140","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa140","url":null,"abstract":"<p><strong>Aims: </strong>Whether diabetes without insulin therapy is an independent cardiovascular (CV) risk factor in atrial fibrillation (AF) has recently been questioned. We investigated the prognostic relevance of diabetes with or without insulin treatment in patients in the ARISTOTLE trial.</p><p><strong>Methods and results: </strong>Patients with AF and increased stroke risk randomized to apixaban vs. warfarin were classified according to diabetes status: no diabetes; diabetes on no diabetes medications; diabetes on non-insulin antidiabetic drugs only; or insulin-treated. The associations between such patient subgroups and stroke/systemic embolism (SE), myocardial infarction (MI), and CV death were examined by Cox proportional hazard regression, both unadjusted and adjusted for other prognostic variables. Patients with diabetes were younger and had a higher body mass index. Median CHA2DS2VASc score was 4.0 in patients with diabetes and 3.0 in patients without diabetes. We found no significant difference in stroke/SE incidence across patient subgroups. Compared with no diabetes, only insulin-treated diabetes was significantly associated with higher risk. When adjusted for clinical variables, compared with no diabetes, the hazard ratios (HRs) for MI (95% confidence intervals) were for diabetes on no medication: 1.15 (0.62-2.14); for diabetes on non-insulin antidiabetic drugs: 1.32 (0.90-1.94); for insulin-treated diabetes: 2.34 (1.43-3.82); interaction P = 0.008. HRs for CV death were for diabetes on no medication: 1.19 (0.86-166); for diabetes on non-insulin antidiabetic drugs: 1.12 (0.88-1.42); for insulin-treated diabetes 1.85 (1.36-2.53), interaction P = 0.001.</p><p><strong>Conclusion: </strong>In anticoagulated patients with AF, a higher risk of MI and CV death is largely confined to diabetes treated with insulin.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"227-235"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38755436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epinephrine administration for adult out-of-hospital cardiac arrest patients with refractory shockable rhythm: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry.","authors":"Tasuku Matsuyama,&nbsp;Sho Komukai,&nbsp;Junichi Izawa,&nbsp;Koichiro Gibo,&nbsp;Masashi Okubo,&nbsp;Kosuke Kiyohara,&nbsp;Takeyuki Kiguchi,&nbsp;Taku Iwami,&nbsp;Bon Ohta,&nbsp;Tetsuhisa Kitamura","doi":"10.1093/ehjcvp/pvab013","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvab013","url":null,"abstract":"<p><strong>Aims: </strong>Little is known about the effect of prehospital epinephrine administration in out-of-hospital cardiac arrest (OHCA) patients with refractory shockable rhythm, for whom initial defibrillation was unsuccessful.</p><p><strong>Methods and results: </strong>This study using Japanese nationwide population-based registry included all adult OHCA patients aged ≥18 years with refractory shockable rhythm between January 2014 and December 2017. Patients with or without epinephrine during cardiac arrest were sequentially matched using a risk set matching based on the time-dependent propensity scores within the same minute. The primary outcome was 1-month survival. The secondary outcomes included 1-month survival with favourable neurological outcome (cerebral performance category scale: 1 or 2) and prehospital return of spontaneous circulation (ROSC). Of the 499 944 patients registered in the database during the study period, 22 877 were included. Among them, 8467 (37.0%) received epinephrine. After time-dependent propensity score-sequential matching, 16 798 patients were included in the matched cohort. In the matched cohort, positive associations were observed between epinephrine and 1-month survival [epinephrine: 17.3% (1454/8399) vs. no epinephrine: 14.6% (1224/8399); RR 1.22 (95% confidence interval, CI: 1.13-1.32)] and prehospital ROSC [epinephrine: 22.2% (1868/8399) vs. no epinephrine: 10.7% (900/8399); RR 2.07 (95% CI: 1.91-2.25)]. No significant positive association was observed between epinephrine and favourable neurological outcome [epinephrine: 7.8% (654/8399) vs. no epinephrine: 7.1% (611/8399); RR 1.13 (95% CI 0.998-1.27)].</p><p><strong>Conclusion: </strong>Using the nationwide population-based registry with time-dependent propensity score-sequential matching analysis, prehospital epinephrine administration in adult OHCA patients with refractory shockable rhythm was positively associated with 1-month survival and prehospital ROSC.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"263-271"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvab013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25378972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive blood pressure control in patients with a history of heart failure: the Systolic Blood Pressure Intervention Trial (SPRINT).","authors":"Manan Pareek,&nbsp;Muthiah Vaduganathan,&nbsp;Christina Byrne,&nbsp;Astrid Duus Mikkelsen,&nbsp;Anna Meta Dyrvig Kristensen,&nbsp;Tor Biering-Sørensen,&nbsp;Kristian Hay Kragholm,&nbsp;Massar Omar,&nbsp;Michael Hecht Olsen,&nbsp;Deepak L Bhatt","doi":"10.1093/ehjcvp/pvab085","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvab085","url":null,"abstract":"The Systolic Blood Pressure Intervention Trial (SPRINT) found that intensive versus standard blood pressure (BP) control reduced cardiovascular morbidity and mortality in high-risk patients.1 Effects were consistent among patients with and without prevalent cardiovascular disease. Patients with heart failure may benefit from intensive BP control by slowing the adverse cardiac remodelling associated with high BP. Conversely, some studies have suggested better outcomes among patients with heart failure who have higher BP.2 Therefore, it remains unknown whether a history of heart failure modifies the risks and benefits of intensive BP control. SPRINT randomized 9361 individuals who were ≥50 years of age, at high cardiovascular risk, and had a systolic BP of 130–180 mmHg to intensive or standard BP control.1 Pertinent exclusion criteria included diabetes, prior stroke, and known symptomatic heart failure within the past 6 months or a left ventricular ejection fraction <35%. The primary endpoint was the composite of acute coronary syndromes, stroke, acute decompensated heart failure, or death from cardiovascular causes. The principal safety endpoint was composite serious adverse events. We used multivariable Cox proportional hazards regression to determine the risk of efficacy and safety events in patients with baseline heart failure. We then calculated the efficacy and safety of intensive versus standard BP control in patients with and without baseline heart failure and examined subgroup heterogeneity using the likelihood-ratio test. A waiver for secondary use of the SPRINT data set was obtained from the Brigham and Women’s Hospital Institutional Review Board. Of the 9361 participants, 326 (3.5%) reported a history of heart failure. The prevalence did not significantly differ between patients randomized to intensive versus standard BP control [166 (3.6%) vs. 160 (3.4%); P = 0.73]. Median follow-up duration was 3.26 years (range 0–4.77 years). A history of heart failure was independently associated with","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"E12-E14"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/ab/pvab085.PMC9071486.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39722464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiovascular effects of gonadotropin-releasing hormone antagonists in men with prostate cancer.","authors":"Filipe Cirne,&nbsp;Nazanin Aghel,&nbsp;Jo-Anne Petropoulos,&nbsp;Laurence Klotz,&nbsp;Daniel J Lenihan,&nbsp;Fred Saad,&nbsp;Jehonathan Pinthus,&nbsp;Darryl P Leong","doi":"10.1093/ehjcvp/pvab005","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvab005","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to determine whether gonadotropin-releasing hormone (GnRH) antagonists (an emerging class of drugs to suppress testosterone synthesis in the treatment of prostate cancer) cause less adverse cardiovascular events than the more commonly use GnRH agonists.</p><p><strong>Methods and results: </strong>We conducted a systematic review to identify all randomized, controlled trials in which a GnRH antagonist was compared with a GnRH agonist in men with prostate cancer. We identified 10 eligible studies including two different GnRH antagonists, degarelix (n = 1681) and relugolix (n = 734), which were compared with the GnRH agonists, leuprolide (n = 714) and goserelin (n = 600). The pooled risk ratios (95% confidence intervals) among GnRH antagonist recipients for adverse cardiovascular events, cardiovascular death, and all-cause mortality were 0.57 (0.39-0.81); 0.49 (0.25-0.96); and 0.48 (0.28-0.83), respectively. Important limitations of the included trials were their short duration of follow-up, unblinded study design and (in most of the studies) the identification of adverse cardiovascular events through safety reporting mechanisms rather than as a pre-specified outcome. There was no evidence of heterogeneity of findings among the studies.</p><p><strong>Conclusions: </strong>There is consistent but methodologically limited data to suggest that GnRH antagonists-a relatively new class of androgen deprivation therapy for prostate cancer-cause significantly less cardiovascular adverse effects than the more frequently used GnRH agonists.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"253-262"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvab005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38838780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subgroup analyses in randomized clinical trials: value and limitations. Review #3 on important aspects of randomized clinical trials in cardiovascular pharmacotherapy.","authors":"Heinz Drexel,&nbsp;Stuart J Pocock,&nbsp;Basil S Lewis,&nbsp;Christoph H Saely,&nbsp;Juan Carlos Kaski,&nbsp;Giuseppe M C Rosano,&nbsp;Gerda Tautermann,&nbsp;Kurt Huber,&nbsp;Joern F Dopheide,&nbsp;Arthur Mader,&nbsp;Alexander Niessner,&nbsp;Gianluigi Savarese,&nbsp;Thomas A Schmidt,&nbsp;Anne Grete Semb,&nbsp;Juan Tamargo,&nbsp;Sven Wassmann,&nbsp;Martin Clodi,&nbsp;Keld Per Kjeldsen,&nbsp;Stefan Agewall","doi":"10.1093/ehjcvp/pvab048","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvab048","url":null,"abstract":"","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"302-310"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39135675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmapulse report-does the arrival of factor XI inhibitors mark the end of the NOAC era?","authors":"Koji Hasegawa,&nbsp;Takanori Ikeda","doi":"10.1093/ehjcvp/pvac003","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvac003","url":null,"abstract":"","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"E9"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39865906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are SGLT2 inhibitors effective against 'all' heart failure with preserved ejection fraction?","authors":"Koji Hasegawa,&nbsp;Basil S Lewis","doi":"10.1093/ehjcvp/pvac004","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvac004","url":null,"abstract":"","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"E10"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39956250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intensive urate lowering therapy with febuxostat in comparison with allopurinol on pulse wave velocity in patients with gout and increased cardiovascular risk: the FORWARD study.","authors":"Giovambattista Desideri,&nbsp;Marek Rajzer,&nbsp;Martijn Gerritsen,&nbsp;Michael T Nurmohamed,&nbsp;Cristina Giannattasio,&nbsp;Anne-Kathrin Tausche,&nbsp;Claudio Borghi","doi":"10.1093/ehjcvp/pvaa144","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa144","url":null,"abstract":"<p><strong>Aims: </strong>Hyperuricaemia and gout are strongly related with traditional cardiovascular risk factors and vascular damage. This study aimed to assess whether febuxostat and allopurinol could differently influence carotid-femoral pulse wave velocity (cfPWV) in patients with gout and elevated serum uric acid (SUA) levels.</p><p><strong>Methods and results: </strong>A multi-centre, multinational, phase IV, randomized, parallel-group, active-controlled, open-label trial with blind endpoints evaluation. One hundred and ninety-seven adults with gout and SUA levels ≥8 mg/dL were randomized to febuxostat or allopurinol in a 1:1 ratio for 36 weeks. The primary outcome was the comparison of the effects of febuxostat and allopurinol on changes in cfPWV. The mean cfPWV values at randomization and Week 36 were 8.69 and 9.00 m/s, respectively for subjects randomized to febuxostat and 9.02 and 9.05 m/s for subjects randomized to allopurinol. No statistically significant changes in cfPWV by treatment assignment were observed at any time point for any of the assessed parameters. More subjects who received febuxostat had serum urate concentrations ≤6 mg/dL following treatment (78.3% vs. 61.1% at Week 36, P = 0.0137). Treatment-emergent adverse events were reported by 51 (52.0%) patients randomized to febuxostat and 63 (62.5%) patients randomized to allopurinol. The majority of events were mild in both treatment groups and included gout flares and arthralgia.</p><p><strong>Conclusion: </strong>In patients with gout and elevated SUA levels the arterial stiffness remained stable both with febuxostat and allopurinol. Febuxostat was more effective and faster than allopurinol in achieving the SUA target. Both treatments were safe and well tolerated.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"236-242"},"PeriodicalIF":7.1,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39127533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}