Impact of Serum Uric Acid Lowering and Contemporary Uric Acid-Lowering Therapies on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis
| Autor: | Ruhong Jiang, Xiaomei Tang, Hangying Ying, Wenpu Guo, Hongdi Yuan, Chenyang Jiang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
cardiovascular outcome Allopurinol 030204 cardiovascular system & hematology Cochrane Library Cardiovascular Medicine Lower risk law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine cardiovascular safety Randomized controlled trial law Internal medicine medicine Diseases of the circulatory (Cardiovascular) system 030203 arthritis & rheumatology business.industry febuxostat uric acid-lowering therapy xanthine oxidase inhibitor chemistry Relative risk Meta-analysis RC666-701 Uric acid Febuxostat Systematic Review Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Frontiers in Cardiovascular Medicine Frontiers in Cardiovascular Medicine, Vol 8 (2021) |
| ISSN: | 2297-055X |
| Popis: | Objective: This study aimed to evaluate the potential association between uric acid (UA) lowering and cardiovascular risk reduction among UA-lowering therapies in adults.Methods: A systematic search for randomized controlled trials (RCTs) was conducted according to the protocol pre-registered in PROSPERO (No. CRD42020199259). We search for RCTs in PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov up to July 1, 2020. A meta-analysis was performed using a fixed- or random-effects model.Results: In total, 30 studies involving 18,585 hyperuricaemic patients were included. Xanthine oxidase inhibitor (XOI) therapy produced a 6.0% reduction in relative risk (RR) for major adverse cardiovascular events (MACEs). The use of febuxostat was associated with a higher risk of cardiovascular events (CVEs) (RR: 1.09, 95% CI 0.998–1.19, I2 = 0.0%), but the difference was not statistically significant. Allopurinol treatment was associated with a lower CVE risk (RR: 0.61, 95% CI 0.46–0.80, I2 = 21.0%). Among the UA-lowering therapies, the drug treatments were associated with all-cause mortality (RR: 1.20, 95% CI 1.02–1.41, I2 = 0.0%). The subgroup with a UA endpoint I2 = 0.0%), and in the subgroup with a UA endpoint I2 = 0.0%).Conclusions: UA reduction caused by XOIs reduced the incidence of MACEs. UA-lowering medicines were associated with changes in all-cause mortality but not cardiovascular outcomes. The lower UA endpoint was not associated with reduced cardiovascular risk. |
| Databáze: | OpenAIRE |
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