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Clinical Trial
. 2005 Jun;91(6):749-53.
doi: 10.1136/hrt.2004.040477.

Allopurinol reduces B-type natriuretic peptide concentrations and haemoglobin but does not alter exercise capacity in chronic heart failure

A D Gavin  1 , A D Struthers
Affiliations
Clinical Trial

Allopurinol reduces B-type natriuretic peptide concentrations and haemoglobin but does not alter exercise capacity in chronic heart failure

A D Gavin et al. Heart. 2005 Jun.

Abstract

Objective: To study whether the effect of allopurinol on improvement of endothelial dysfunction in chronic heart failure (CHF) translates into improved exercise capacity and to examine whether allopurinol also improves B-type natriuretic peptide (BNP), the other important prognostic marker of CHF.

Design: Randomised, double blind, placebo controlled crossover trial.

Setting: Teaching hospital.

Patients: 50 patients with CHF (New York Heart Association functional classes II and III) were recruited.

Interventions: 50 patients with CHF were randomly assigned to three months' treatment with allopurinol (300 mg/day) or placebo. At two and three months into treatment, they underwent a modified Bruce exercise protocol and a six minute walk test. Blood was taken for BNP and haemoglobin analysis.

Results: Neither exercise test was altered by allopurinol. However, plasma BNP concentrations fell significantly (p = 0.035) with allopurinol (11.9 pmol/l) versus placebo (14.4 pmol/l). Haemoglobin concentrations also fell highly significantly with allopurinol (p = 0.001).

Conclusions: An important negative finding is that despite high hopes for it, allopurinol had no effect on exercise capacity in CHF. On the other hand, allopurinol did reduce BNP, which is the best available surrogate marker for prognosis in CHF.

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Figures

Figure 1
Figure 1
Effect of allopurinol on plasma B-type natriuretic peptide (BNP) concentrations in patients with chronic heart failure (CHF). Data are mean (SEM). *p<0.05.
Figure 2
Figure 2
Effect of allopurinol on treadmill performance of patients with CHF. Data are mean (SEM). NS, not significant.
Figure 3
Figure 3
Effect of allopurinol on the six minute walk test in patients with CHF. Data are mean (SEM).
Figure 4
Figure 4
Effect of allopurinol on total cholesterol in patients with CHF. Data are mean (SEM). *p<0.05.
Figure 5
Figure 5
Effect of allopurinol on haemoglobin (Hb) in patients with CHF. Data are mean (SEM). *p<0.05; **p<0.001.
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