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Association between long-term prescription of febuxostat and the progression of heart failure with preserved ejection fraction in patients with hypertension and asymptomatic hyperuricemia

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Abstract

Both hypertension and hyperuricemia are closely associated with the morbidity and mortality of heart failure. This study was designed to evaluate the influences of long-term xanthine oxidase inhibitor (febuxostat) prescription on left ventricular hypertrophy (LVH), left ventricular (LV) diastolic function, and new-onset heart failure with preserved ejection fraction (HFpEF) in these patients. Using a propensity score matching of 1:2 ratio, this retrospective claims database study compared febuxosatat prescription (n = 96) and non-urate-lowering therapy (n = 192) in patients with hypertensive left ventricular hypertrophy (LVH) and asymptomatic hyperuricemia. With a follow-up of 36 months, febuxostat significantly decreased the level of serum uric acid as well as generated more prominent improvement in LVH and LV diastolic function. Besides, the new-onset symptomatic HFpEF occurred in 2 of 96 patients in febuxostat group and 13 of 192 patients in non-urate-lowering group (P = 0.091). No increased risk for major adverse cardiovascular events in patients prescribed with febuxostat was noted. In conclusion, long-term febuxostat exposure was associated with protective effects in terms of LVH or LV diastolic dysfunction in patients with hypertensive LVH and asymptomatic hyperuricemia. Febuxostat also displayed a trend for reduced risk of new-onset HFpEF in this population.

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Funding

This study was supported by Clinical Research Program of 9th People’s Hospital affiliated to Shanghai Jiaotong University School of Medicine (JYLJ201803), research projects from Shanghai Science and Technology Commission (18411950500) and Shanghai Shenkang Hospital Development Center (16CR2034B).

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Authors and Affiliations

  1. Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, No. 639 Zhizaoju road, Shanghai, 200011, People’s Republic of China

    Jian-an Pan, Hao Lin, Chang-qian Wang, Jun-feng Zhang & Jun Gu

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  1. Jian-an Pan
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  2. Hao Lin
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Correspondence to Jun-feng Zhang or Jun Gu.

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Pan, Ja., Lin, H., Wang, Cq. et al. Association between long-term prescription of febuxostat and the progression of heart failure with preserved ejection fraction in patients with hypertension and asymptomatic hyperuricemia. Heart Vessels 35, 1446–1453 (2020). https://doi.org/10.1007/s00380-020-01619-8

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