Comparison of Febuxostat and Allopurinol for Hyperuricemia in Cardiac Surgery Patients (NU-FLASH Trial)
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概要
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Background: Febuxostat has been reported to have a stronger effect on hyperuricemia than allopurinol. Methods and Results: Cardiac surgery patients with hyperuricemia (n=141) were randomized to a febuxostat group or an allopurinol group. The study was single-blind, so the treatment was not known by the investigators. The primary endpoint was serum uric acid (UA) level. Secondary endpoints included serum creatinine, urinary albumin, cystatin-C, oxidized low-density lipoprotein (LDL), eicosapentaenoic acid/arachidonic acid ratio, total cholesterol, triglycerides, LDL, high-density lipoprotein, high-sensitivity C-reactive protein, blood pressure, heart rate, pulse wave velocity (PWV), ejection fraction, left ventricular mass index (LVMI), and adverse reactions. UA level was significantly lower in the febuxostat group than the allopurinol group from 1 month of treatment onward. Serum creatinine, urinary albumin, cystatin-C and oxidized LDL were also significantly lower in the febuxostat group. There were no significant changes in systolic blood pressure, PWV, and LVMI in the allopurinol group, but these parameters all had a significant decrease in the febuxostat group. Conclusions: Febuxostat was effective for high-risk cardiac surgery patients with hyperuricemia because it reduced UA more markedly than allopurinol. Febuxostat also had a renoprotective effect, inhibited oxidative stress, showed anti-atherogenic activity, reduced blood pressure, and decreased PWV and LVMI.
著者
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Sezai Akira
Department Of Cardiovascular Surgery Nihon University School Of Medicine
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YOSHITAKE ISAMU
Department of Cardiovascular Surgery, Nihon University School of Medicine
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Yoshitake Isamu
Department Of Cardiovascular Surgery Nihon University School Of Medicine
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Soma Masayoshi
Department Of Endocrinology Nihon University School Of Medicine
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Hata Mitsumasa
Department Of Cardiac Surgery Austin & Repatriation Medical Centre University Of Melbourne
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Wakui Shinji
Department Of Cardiovascular Surgery Nihon University School Of Medicine
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Shiono Motomi
Department Of Cardiovascular Surgery Nihon University School Of Medicine
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Nakata Kin-ichi
Department Of Cardiovascular Surgery Nihon University School Of Medicine
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HATA Hiroaki
Department of Cardiovascular Surgery, Nihon University School of Medicine
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Hata Hiroaki
Department of Applied Chemistry, Faculty of Science and Technology, Chuo University, Bunkyo, Tokyo 112-8551, Japan
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Soma Masayoshi
Department of General Medicine, Nihon University School of Medicine
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