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The role of urate and xanthine oxidase inhibitors in cardiovascular disease.
Cardiovasc Ther. 2008 Spring; 26(1):59-64.CT

Abstract

Many studies have shown a strong correlation between urate levels and cardiovascular disease. The formation of urate is complex as the same enzyme that produces urate, xanthine oxidase (XO) also catalyzes the formation of reactive oxygen species (ROS). There is some evidence that the urate molecule has free radical scavenging properties in vitro and acute infusions of urate improve endothelial function in at-risk populations. High levels of ROS are clearly linked to worse outcome in a variety of conditions. Allopurinol has been the archetypal XO inhibitor for over 40 years. Small studies have demonstrated its beneficial effects, mainly in heart failure but also in a variety of other cohorts of patients with cardiovascular risk. It is a safe agent, provided suitable patients are chosen and monitored carefully. Newer promising agents like oxypurinol have not shown the expected benefits in larger multicentered studies. This review looks at the biology of urate, its role in cardiovascular disease, the possible mechanisms by which XO inhibitors exert their beneficial effect on endothelial dysfunction, and examines the possible causes for the failure of newer agents to live up to expectations.

Authors+Show Affiliations

Department of Clinical Pharmacology, University of Dundee, Dundee, UK.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18466421

Citation

George, Jacob, and Allan D. Struthers. "The Role of Urate and Xanthine Oxidase Inhibitors in Cardiovascular Disease." Cardiovascular Therapeutics, vol. 26, no. 1, 2008, pp. 59-64.
George J, Struthers AD. The role of urate and xanthine oxidase inhibitors in cardiovascular disease. Cardiovasc Ther. 2008;26(1):59-64.
George, J., & Struthers, A. D. (2008). The role of urate and xanthine oxidase inhibitors in cardiovascular disease. Cardiovascular Therapeutics, 26(1), 59-64. https://doi.org/10.1111/j.1527-3466.2007.00029.x
George J, Struthers AD. The Role of Urate and Xanthine Oxidase Inhibitors in Cardiovascular Disease. Cardiovasc Ther. 2008;26(1):59-64. PubMed PMID: 18466421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of urate and xanthine oxidase inhibitors in cardiovascular disease. AU - George,Jacob, AU - Struthers,Allan D, PY - 2008/5/10/pubmed PY - 2008/6/5/medline PY - 2008/5/10/entrez SP - 59 EP - 64 JF - Cardiovascular therapeutics JO - Cardiovasc Ther VL - 26 IS - 1 N2 - Many studies have shown a strong correlation between urate levels and cardiovascular disease. The formation of urate is complex as the same enzyme that produces urate, xanthine oxidase (XO) also catalyzes the formation of reactive oxygen species (ROS). There is some evidence that the urate molecule has free radical scavenging properties in vitro and acute infusions of urate improve endothelial function in at-risk populations. High levels of ROS are clearly linked to worse outcome in a variety of conditions. Allopurinol has been the archetypal XO inhibitor for over 40 years. Small studies have demonstrated its beneficial effects, mainly in heart failure but also in a variety of other cohorts of patients with cardiovascular risk. It is a safe agent, provided suitable patients are chosen and monitored carefully. Newer promising agents like oxypurinol have not shown the expected benefits in larger multicentered studies. This review looks at the biology of urate, its role in cardiovascular disease, the possible mechanisms by which XO inhibitors exert their beneficial effect on endothelial dysfunction, and examines the possible causes for the failure of newer agents to live up to expectations. SN - 1755-5914 UR - https://www.unboundmedicine.com/medline/citation/18466421/The_role_of_urate_and_xanthine_oxidase_inhibitors_in_cardiovascular_disease_ DB - PRIME DP - Unbound Medicine ER -