Xanthine-oxidase inhibitors and statins in chronic heart failure: Effects on vascular and functional parameters

Douglas Greig, Hernan Alcaino, Pablo F. Castro, Lorena Garcia, Hugo E. Verdejo, Mario Navarro, Rafael Lpez, Rosemarie Mellado, Fabiola Tapia, Luigi A. Gabrielli, Camilo Nogerol, Mario Chiong, Ivan Godoy, Sergio Lavandero

Resultado de la investigación: Contribución a una revistaArtículorevisión exhaustiva

26 Citas (Scopus)

Resumen

Background: Increased oxidative stress in heart failure (HF) leads to inflammation and endothelial dysfunction (ED). Both statins and allopurinol have known anti-oxidant properties, but their utility in HF has not been fully assessed. Methods: This investigation was a prospective, double-blind, double-dummy study, performed between March 2007 and June 2009. Seventy-four HF patients, with New York Heart Association (NYHA) Class II or III status and left ventricular ejection fraction (LVEF) <40%, were included. Patients received placebo during 4 weeks and were then randomized to receive 4 weeks of either atorvastatin 20 mg/day plus placebo (ATV+PLA group) or atorvastatin 20 mg/day orally plus allopurinol 300 mg/day orally (ATV+ALLO group). Malondialdehyde (MDA), extracellular superoxide dismutase (ecSOD) activity and uric acid (UA) levels, among others, were determined at baseline and after 4 weeks of treatment. ED was assessed by flow-dependent endothelial-mediated vasodilation (FDD), and functional capacity by 6-minute walk test (6MWT). Results: Thirty-two patients were randomized to ATV+PLA and 38 to ATV+ALLO. Mean age was 59 ± 2 years, 82% were male, and 22% had an ischemic etiology. Hypertension was present in 60% and diabetes in 15% of those studied. No significant differences were observed between baseline measurements and after placebo. After 4 weeks of treatment, both groups showed a significant decrease on MDA (0.9 ± 0.1 to 0.8 ± 0.1 and 1.0 ± 0.5 to 0.9 ± 0.1 μmol/liter, p = 0.88), UA (7.4 ± 0.4 to 6.8 ± 0.3 and 7.2 ± 0.4 to 5.0 ± 0.3 mg/dl, p < 0.01) and FDD (3.9 ± 0.2% to 5.6 ± 0.4% and 4.6 ± 0.3% to 7.1 ± 0.5%, p = 0.07) with increased ecSOD activity (109 ± 11 to 173 ± 13 and 98 ± 10 to 202 ± 16, U/ml/min, p = 0.41) and improved 6MWT (447 ± 18 to 487 ± 19 and 438 ± 17 to 481 ± 21 m, p = 0.83), with all values for ATV+PLA and ATV+ALLO, respectively; p-values are for comparison between groups after treatment. Conclusion: Short-term ATV treatment in heart failure (HF) patients reduces oxidative stress and improves FDD and functional capacity. These beneficial effects are not strenghthened by the addition of alopurinol.

Idioma originalInglés
Páginas (desde-hasta)408-413
Número de páginas6
PublicaciónJournal of Heart and Lung Transplantation
Volumen30
N.º4
DOI
EstadoPublicada - 1 abr 2011

Áreas temáticas de ASJC Scopus

  • Cirugía
  • Neumología
  • Cardiología y medicina cardiovascular
  • Transplantes

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