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

Dawson, Jesse; Robertson, Michele; Dickie, David Alexander; Bath, PM; Forbes, Kirsten; Quinn, Terence J; Broomfield, Niall M.; Dani, Krishna; Doney, Alex S.F.; Houston, Graeme; Lees, Kennedy R.; Muir, Keith W.; Struthers, Allan D.; Walters, Matthew; Barber, Mark; Bhalla, Ajay; Cameron, Alan C.; Dyker, A; Guyler, Paul; Hassan, Ahamad; Kearney, Mark T.; Keegan, Breffni; Sekaran, Lakshmanan; MacLeod, Mary Joan; Randall, Marc; Shaw, Louise; Subramanian, Ganesh; Werring, David J.; McConnachie, Alex

doi:10.1016/j.eclinm.2023.101863

Cited by 5 publications

(3 citation statements)

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“…All participants gave written informed consent. The trial protocol [ 24 ] and main results [ 21 ] have been published.…”

Section: Methodsmentioning

confidence: 99%

“…In a recent systematic review and meta-analysis, uric acid lowering treatment reduced the risk of major adverse cardiovascular events in those with prior cardiovascular disease [ 14 ]. In a recent trial, allopurinol use led to a reduction in systolic BP [ 21 ]. In addition, allopurinol may have additional effects on BP and BPV independent of urate lowering.…”

Section: Introductionmentioning

confidence: 99%

“…However, the effects of allopurinol on BPV remain unclear. This study aimed to investigate the effect of allopurinol on measures of BPV in people with recent ischemic stroke or transient ischemic attack (TIA) using data from the Xanthine oxidase inhibition for the Improvement of Long-term Outcomes Following Ischemic Stroke and Transient ischemic attack (XILO-FIST) trial [ 21 ]. We also aimed to assess whether there was a relationship between BPV and white matter hyperintensity (WMH) progression, brain atrophy, and cognitive function.…”

Section: Introductionmentioning

confidence: 99%

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Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST

MACDONALD,

MCCONNACHIE,

DICKIE

et al. 2024

J Hum Hypertens

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Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18–2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31–2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.

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“…All participants gave written informed consent. The trial protocol [ 24 ] and main results [ 21 ] have been published.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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