Evidence map›Paper›PMID 23449426›Full record

Trial reportJournal of the American College of Cardiology2013

High-dose allopurinol reduces left ventricular mass in patients with ischemic heart disease.

Sushma Rekhraj, Stephen J Gandy, Benjamin R Szwejkowski, M Adnan Nadir, Awsan Noman, J Graeme Houston, Chim C Lang, Jacob George, Allan D Struthers

2 registry-linked trialsAbstract readControlled Clinical TrialRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 66 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 5 pooled it
10.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03353298 phase2completednot on this mapstarted 2018, after this paper: background citation

A Randomized, Double-blind, Placebo-controlled, 9-month, Parallel Group Study of Allopurinol to Reduce Left Ventricular Mass in Living Kidney Donors (AL-DON)

TypeinterventionalSponsorOslo University HospitalRan2018 to 2020Enrolled71ConditionsRenal Transplant Donor of Left Kidney, Renal Transplant Donor of Right KidneyArmsAllopurinol 300 mg, Placebo Oral Tablet
NCT03700645 phase4unknown statusnot on this mapstarted 2018, after this paper: background citation

Allopurinol in the Treatment of Patients With Diabetes Mellitus and Multivessel Coronary Artery Disease Treated by Either PCI or CABG: Pilot Study

TypeinterventionalSponsorTel-Aviv Sourasky Medical CenterRan2018 to 2020Enrolled100ConditionsDiabetes Mellitus, Ischemic Heart Disease, Multi Vessel Coronary Artery DiseaseArmsAllopurinol
3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 5 syntheses or guidelines pooled it, 151 citations in OpenAlex.

  1. Efficacy of Allopurinol in Improving Endothelial Dysfunction: A Systematic Review and Meta-Analysis.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023
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  5. Effects of Allopurinol on Arterial Stiffness: A Meta-Analysis of Randomized Controlled Trials.Medical science monitor : international medical journal of experimental and clinical research · 2016
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  9. Allopurinol in Patients with Pulmonary Hypertension Associated with Chronic Lung Disease.International journal of chronic obstructive pulmonary disease · 2020
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6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Sushma RekhrajDivision of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom.
Stephen J Gandy
Benjamin R Szwejkowski
M Adnan Nadir
Awsan Noman
J Graeme Houston
Chim C Lang
Jacob George
Allan D Struthers
University of Dundee · GBNinewells Hospital · GB

Funding

Medical Research Council G0701592
6 · The paper itself

Abstract

objectivesThis study sought to ascertain if high-dose allopurinol regresses left ventricular mass (LVM) in patients with ischemic heart disease (IHD).

backgroundLV hypertrophy (LVH) is common in patients with IHD including normotensive patients. Allopurinol, a xanthine oxidase inhibitor, has been shown to reduce LV afterload in IHD and may therefore also regress LVH.

methodsA randomized, double-blind, placebo-controlled, parallel group study was conducted in 66 patients with IHD and LVH, comparing 600 mg/day allopurinol versus placebo therapy for 9 months. The primary outcome measure was change in LVM, assessed by cardiac magnetic resonance imaging (CMR). Secondary outcome measures were changes in LV volumes by CMR, changes in endothelial function by flow-mediated dilation (FMD), and arterial stiffness by applanation tonometry.

resultsCompared to placebo, allopurinol significantly reduced LVM (allopurinol -5.2 ± 5.8 g vs. placebo -1.3 ± 4.48 g; p = 0.007) and LVM index (LVMI) (allopurinol -2.2 ± 2.78 g/m(2) vs. placebo -0.53 ± 2.5 g/m(2); p = 0.023). The absolute mean difference between groups for change in LVM and LVMI was -3.89 g (95% confidence interval: -1.1 to -6.7) and -1.67 g/m(2) (95% confidence interval: -0.23 to -3.1), respectively. Allopurinol also reduced LV end-systolic volume (allopurinol -2.81 ± 7.8 mls vs. placebo +1.3 ± 7.22 mls; p = 0.047), improved FMD (allopurinol +0.82 ± 1.8% vs. placebo -0.69 ± 2.8%; p = 0.017) and augmentation index (allopurinol -2.8 ± 5.1% vs. placebo +0.9 ± 7%; p = 0.02).

conclusionsHigh-dose allopurinol regresses LVH, reduces LV end-systolic volume, and improves endothelial function in patients with IHD and LVH. This raises the possibility that allopurinol might reduce future cardiovascular events and mortality in these patients. (Does a Drug Allopurinol Reduce Heart Muscle Mass and Improve Blood Vessel Function in Patients With Normal Blood Pressure and Stable Angina?; ISRCTN73579730).

Indexed as

AgedAllopurinolDouble-Blind MethodFemaleHumansHypertrophy, Left VentricularMagnetic Resonance ImagingMaleManometryMyocardial IschemiaAllopurinol

Identifiers

PMID23449426
OpenAlexW1998243058

What OpenQuestion holds

Textmetadata
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.