Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART): a multicentre, prospective, randomised, open-label, blinded-endpoint trial

Mackenzie, Isla S.; Hawkey, Christopher J.; Ford, Ian; Greenlaw, Nicola; Pigazzani, Filippo; Rogers, Amy; Struthers, Allan D.; Begg, Alan; Wei, Li; Avery, Anthony; Taggar, Jaspal; Walker, Andrew; Duce, Suzanne L.; Barr, Rebecca; Dumbleton, Jennifer; Rooke, Evelien D; Townend, Jonathan N.; Ritchie, Lewis D; MacDonald, Thomas M.; Ahmed, Husnat; Arthur, Peter G.; Aziz, Jane; Barnes, Lawrence J.; Boyle, Sarah; Brighton, Tom; Brown, Morris J.; Caulfield, Mark; Dawson, Jesse; Denvir, Martin A.; Doney, Alex S.F.; Doshi, Sagar N.; Dryburgh, Moira; Eddleston, Michael; Finlayson, Jim; Fuat, Ahmet; Furnace, Jacqueline; Grieve, JW Kerr; Guthrie, Greg; Ham, Sharon; Isaard, Emma; Jennings, Claudine G.; Johnson, Richard J.; Kerr, Claire; Khan, Sohail; Krishnan, Kailash; Long, Susan; Mackintosh, Anne; MacLeod, Mary Joan; McCormack, Terry; McEleny, Paul; Morar, Monique; Nadir, Adnan; Newby, David E.; Petrie, Colin J.; Preiss, David; Ralston, Stuart H.; Randall, Marc; Routledge, Helen; Shakir, Saad; Sharma, Raj Kumar; Shepherd, Bridget; Sims, Don; Snedden, Gordon; Trevelyan, Jasper; Weir, Christopher J.; Weir, Robin A.P.; Wetherall, Kirsty; Wilson, Robbie S.; Wilson, Adam; Zutis, Kris

doi:10.1016/s0140-6736(22)01657-9

Cited by 89 publications

(57 citation statements)

References 31 publications

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“…More recently, the ALLHEART study was published in which older patients (age >60 years) with a history of ischemic heart disease and no gout were randomized to allopurinol or placebo and followed for almost 5 years without any discernible benefit on subsequent cardiovascular events. 51 However, similar to the other trials, patients with normal uric acid levels were included (the mean serum uric acid was 5.6 mg/dl) and gout was excluded. Likewise, there was a large (57%) dropout which were included in the analysis because it was an intention-to-treat study, such that it was not truly testing whether the treatment of hyperuricemia is beneficial on cardiac endpoints.…”

Section: Gout and Ckdmentioning

confidence: 99%

Uric Acid and Chronic Kidney Disease: Still More to Do

Johnson¹,

Sánchez-Lozada²,

Lanaspa³

et al. 2023

Kidney International Reports

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Section: Gout and Ckdmentioning

confidence: 99%

Uric Acid and Chronic Kidney Disease: Still More to Do

Johnson¹,

Sánchez-Lozada²,

Lanaspa³

et al. 2023

Kidney International Reports

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“…The recently reported Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART) study found no difference in the rate of a composite primary outcome of non-fatal myocardial infarction, non-fatal stroke, or cardiovascular death (or in any secondary outcome) in approximately 6000 participants with ischaemic heart disease. 31 There was also no suggestion of benefit in people in the highest tertile of serum uric acid levels.…”

Section: Discussionmentioning

confidence: 99%

Xanthine oxidase inhibition and white matter hyperintensity progression following ischaemic stroke and transient ischaemic attack (XILO-FIST): a multicentre, double-blinded, randomised, placebo-controlled trial

Dawson¹,

Robertson²,

Dickie³

et al. 2023

eClinicalMedicine

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“…In 2020, two large randomized clinical trials (RCTs) found no benefit of allopurinol in slowing renal progression [ 63 , 64 ]. The ALLHEART study included older patients (>age 60) with a history of ischemic heart disease and no gout who were randomized into allopurinol or placebo groups and followed for five years without any cardioprotective effect [ 65 ]. In a more recent meta-analysis of 16 RCTs involving 1943 patients, a prescribed ULD (allopurinol, febuxostat, and benzbromarone) was not found to have a renoprotective effect compared with a placebo.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

et al. 2022

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Background: The prevalence of chronic kidney disease (CKD) correlates with the prevalence of hypertension (HT). We studied the prevalence and predictors of CKD in a representative sample of the Romanian adult population. Methods: A sample of 1470 subjects were enrolled in the SEPHAR IV (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk) survey. All subjects were evaluated for blood pressure (BP) and extensive evaluations of target organ damage, blood, and urine samples were undertaken. Results: A total of 883 subjects were included in the statistical analysis. Those experiencing CKD with an eGFR < 60 mL/min/1.73 m2 were older at 71.94 ± 7.4 years (n = 19, 2.15%) compared with those without renal impairment at 50.3 ± 16.21 years (n = 864, 97.85%), p < 0.0001. The prevalence of CKD among hypertensives (379 from 883) was 4.49% (17/379), while 17 out of 19 subjects with CKD had HT (89.47%). After adjusting for age, sex, and diabetic status, only serum uric acid (SUR) > 6.9 mg/dL (OR: 6.61; 95% CI: 2.063, 10.83; p = 0.004) was an independent risk factor and a predictor of CKD. Conclusions: The prevalence of CKD in hypertensive Romanian adults was more than ten times higher than in the normotensive population. Levels of SUR > 6.9 mg/dL were predictors of CKD.

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Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART): a multicentre, prospective, randomised, open-label, blinded-endpoint trial

Cited by 89 publications

References 31 publications

Uric Acid and Chronic Kidney Disease: Still More to Do

Uric Acid and Chronic Kidney Disease: Still More to Do

Xanthine oxidase inhibition and white matter hyperintensity progression following ischaemic stroke and transient ischaemic attack (XILO-FIST): a multicentre, double-blinded, randomised, placebo-controlled trial

Prevalence and Predictors of Renal Disease in a National Representative Sample of the Romanian Adult Population: Data from the SEPHAR IV Survey

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