August 10th, 2010
Allopurinol in Gout and Heart Failure
Larry Husten, PHD
Thanassoulis and colleagues analyzed data from 25,000 Canadian heart failure (HF) patients in a paper appearing in Archives of Internal Medicine. They found that patients with a recent or remote history of gout were at high risk for HF readmission or death. Although there was no significant association between allopurinol use in the overall study population, among patients with a history of gout, allopurinol use was associated with a significant reduction in HF events. The authors conclude that “given the limited novel treatment options available for HF patients, allopurinol may be an important therapeutic consideration in certain subgroups of patients with HF.”
One Response to “Allopurinol in Gout and Heart Failure”
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Allopurinol only for those patients with gout.
It is satisfying that allopurinol may have additional beneficial properties in HF pts with gout. Let those pts be treated with allopurinol which is indicated for the diagnosis. Yet I can see a large number of colleagues to treat hyperuricemia in patiens without gout who have asymptomatic hyperuricemia for various reasons. In this setting there is no place for allopurionol as no clinically relevant evidence in risk reduction has ever been found or incoroporated into any guidelines. Such treatment is not warranted and therefore contraindicated. One should be careful not to mix the indications for the drug in cardiac pts.
I´ll welcome some reasoning for treatment in pts without gout.