嘌呤黄嘌呤氧化酶抑制剂不利于慢性心力衰竭的预后：荟萃分析。

IF 2.4 3区医学 Q3 PHARMACOLOGY & PHARMACY

European Journal of Clinical Pharmacology Pub Date : 2025-05-10 DOI:10.1007/s00228-025-03848-0

Lin Ye, Anyi Xu, Jianing Huang, Yeyuan Zhang, Jie Yao, Fang Wang

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引用次数: 0

摘要

背景：根据以往的研究，黄嘌呤氧化酶抑制剂（XOIs）对慢性心力衰竭（CHF）患者的疗效仍存在争议。因此，本研究的目的是探讨XOIs对CHF患者的疗效。方法：截至2024年7月，我们检索PubMed、EMBASE、Medline、Web of Science和Cochrane Library，检索有关XOI对CHF患者疗效的研究。主要结果包括全因死亡率、心血管死亡率和心力衰竭住院率。采用风险比（HR）和95%置信区间（95% CI）对结果进行评价。结果：本荟萃分析共纳入8项研究，其中5项为队列研究，3项为随机对照试验（rct）。总样本量为301,345。实验组分别给予别嘌呤醇或羟基嘌呤醇。实验组的全因死亡率（HR = 1.26, 95% CI 1.05 ~ 1.51, p = 0.013）和CV死亡率（HR = 1.58, 95% CI 1.17 ~ 2.14, p = 0.03）均高于对照组。在HF住院方面，两组差异无统计学意义（HR = 1.21, p = 0.292）。亚组分析显示，无论频率和剂量水平如何，实验组的CV住院率均高于对照组。低剂量组全因死亡率高于对照组（HR = 1.39, p = 0.033）。低剂量组（HR = 1.55, p = 0.006）和流行组（HR = 1.50, p = 0.042）的CV死亡率均高于对照组。结论：嘌呤XOI暴露可能对CHF患者的预后不利，并受使用频率和剂量的影响。

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Purine xanthine oxidase inhibitors are not conducive to the prognosis of chronic heart failure: a meta-analysis.

Background: According to previous studies, the efficacy of xanthine oxidase inhibitors (XOIs) in patients with chronic heart failure (CHF) is still controversial. Therefore, the purpose of this study was to investigate the efficacy of XOIs in patients with CHF.

Methods: Up to July 2024, we searched PubMed, EMBASE, Medline, Web of Science, and Cochrane Library for studies on the efficacy of XOI in patients with CHF. The main results included all-cause mortality, cardiovascular (CV) mortality, and heart failure (HF) hospitalization rates. The results were evaluated by hazard ratio (HR) and 95% confidence interval (95% CI).

Results: A total of eight studies were included in this meta-analysis, of which five were cohort studies and three were randomized controlled trials (RCTs). The total sample size was 301,345. The experimental group was exposed to allopurinol or hydroxypurinol. The all-cause mortality (HR = 1.26, 95% CI 1.05-1.51, p = 0.013) and CV mortality (HR = 1.58, 95% CI 1.17-2.14, p = 0.03) in the experimental group were higher than those in the control group. In terms of HF hospitalization, there was no difference between both groups (HR = 1.21, p = 0.292). Subgroup analysis showed that the CV hospitalization rate of the experimental group was higher than that of the control group, regardless of frequency and dose levels. The all-cause mortality in the low-dose group was higher than that in the control group (HR = 1.39, p = 0.033). The CV mortality of the low-dose group (HR = 1.55, p = 0.006) and the prevalent group (HR = 1.50, p = 0.042) was higher than that of the control group.

Conclusion: Purine XOI exposure may be unfavorable for the prognosis of CHF patients and is affected by the frequency and dose of use.

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来源期刊

European Journal of Clinical Pharmacology 医学-药学

CiteScore

5.40

自引率

3.40%

发文量

170

审稿时长

3-8 weeks

期刊介绍： The European Journal of Clinical Pharmacology publishes original papers on all aspects of clinical pharmacology and drug therapy in humans. Manuscripts are welcomed on the following topics: therapeutic trials, pharmacokinetics/pharmacodynamics, pharmacogenetics, drug metabolism, adverse drug reactions, drug interactions, all aspects of drug development, development relating to teaching in clinical pharmacology, pharmacoepidemiology, and matters relating to the rational prescribing and safe use of drugs. Methodological contributions relevant to these topics are also welcomed. Data from animal experiments are accepted only in the context of original data in man reported in the same paper. EJCP will only consider manuscripts describing the frequency of allelic variants in different populations if this information is linked to functional data or new interesting variants. Highly relevant differences in frequency with a major impact in drug therapy for the respective population may be submitted as a letter to the editor. Straightforward phase I pharmacokinetic or pharmacodynamic studies as parts of new drug development will only be considered for publication if the paper involves -a compound that is interesting and new in some basic or fundamental way, or -methods that are original in some basic sense, or -a highly unexpected outcome, or -conclusions that are scientifically novel in some basic or fundamental sense.