Romanian Society of Pharmaceutical Sciences
 

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EFFECTS OF HIGH DOSES OF ALLOPURINOL ON SERUM URIC ACID AND CARDIAC BIOMARKERS IN CHRONIC HEART FAILURE

ADRIANA ILIEŞIU1*, ALEXANDRU CÂMPEANU1, DACIANA MARTA2, GABRIELA USCOIU1, IRINA PÂRVU1, ANA CIOBANU1, MARIANA JINGA3, GABRIELA GHEORGHE1

1.”Carol Davila” University of Medicine and Pharmacy, "Prof. Dr. Th. Burghele” Clinical Hospital, Department of Internal Medicine and Cardiology, 20th Panduri Rd, Bucharest, Romania
2.”Victor Babes” National Institute of Pathology and Biomedical Research, 99-101th Splaiul Independentei St, Bucharest, Romania
3.”Dr. Carol Davila” Central Military Emergency Hospital, Department of Internal Medicine, 88th Mircea Vulcanescu St., Bucharest, Romania

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Allopurinol, by xanthine oxidase inhibition, could be a therapeutic option in patients with chronic heart failure (CHF). The purpose of the study was to assess the effects of high dose allopurinol on serum uric acid (sUA) and cardiac biomarkers, Nterminal pro-brain natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15) and osteopontin (OPN), in patients with CHF. In 57 patients with stable CHF, New York Heart Association (NYHA) class III and reduced systolic function, under optimal medical therapy, ejection fraction (EF) and E/e’ ratio as markers of left ventricular function were assessed by echocardiography. sUA, NT-proBNP, GDF-15 and OPN were measured before and after 6 months of treatment with allopurinol 600 mg/day. Patients with elevated filling pressures (E/e’ ≥ 13) at baseline had lower EF and higher levels of NTproBNP, GDF 15 and sUA. After 6 months, for 23 patients (40%) who improved their NYHA class, also the levels of NTproBNP and GDF 15 decreased, along with lower sUA values. OPN was elevated at baseline and increased even further after 6 months, being unaffected by the CHF clinical course. Treatment with high doses of allopurinol was favourable, but heterogeneous effects were registered on cardiac biomarkers in CHF patients. Since the therapeutic benefits were associated with important sUA level decrease, sUA is a useful marker of CHF outcome and efficiency of allopurinol treatment.