SynthesisBMC cardiovascular disorders2018
Xanthine oxidase inhibitors for prevention of cardiovascular events: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in BMC cardiovascular disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
84 citing papers in PubMed, 8 syntheses or guidelines pooled it, 190 citations in OpenAlex.
- Cardiovascular Outcomes of Uric Acid Lowering Medications: A Meta-Analysis.Current cardiology reports · 2024Pooled it
- Efficacy of Allopurinol in Improving Endothelial Dysfunction: A Systematic Review and Meta-Analysis.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Pooled it
- Pooled it
- Urate, Blood Pressure, and Cardiovascular Disease: Evidence From Mendelian Randomization and Meta-Analysis of Clinical Trials.Hypertension (Dallas, Tex. : 1979) · 2021Pooled it
- Allopurinol to reduce cardiovascular morbidity and mortality: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Effect of Uric Acid-Lowering Agents on Patients With Heart Failure: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Frontiers in cardiovascular medicine · 2021Pooled it
- Cardiovascular Safety of Febuxostat and Allopurinol in Hyperuricemic Patients With or Without Gout: A Network Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Prognostic value of serum uric acid in patients with acute heart failure: A meta-analysis.Medicine · 2019Pooled it
- Trial
- Comparative effects of topiroxostat and febuxostat on arterial properties in hypertensive patients with hyperuricemia.Journal of clinical hypertension (Greenwich, Conn.) · 2021Trial
- Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: A randomized, controlled trial.PLoS medicine · 2020Trial
- How much allopurinol does it take to get to target urate? Comparison of actual dose with creatinine clearance-based dose.Arthritis research & therapy · 2018Trial
- Introducing Allopurinol to the Medical Treatment of Marfan Syndrome: Advantages, Limitations, and Potential Extension to other Aortopathies.Cardiovascular drugs and therapy · 2026Review
- Observational
- Acute cardiovascular events after discontinuation of xanthine oxidase inhibitors: a cohort study.Clinical rheumatology · 2026Article
- Article
- A Redox-Active and Electroactive Hydrogel Enabled by an Integrated PEDOT@PMOF Nanofiller for Post-Infarct Myocardial Repair.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Causal Relationship Between Serum Uric Acid and Atherosclerotic Disease: A Mendelian Randomization and Transcriptomic Analysis.Biomedicines · 2025Article
- Targeting ryanodine receptors with allopurinol and xanthine derivatives for the treatment of cardiac and musculoskeletal weakness disorders.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Exploratory Data Analysis of the In Vitro Effects of Novel Hydrazide-Hydrazone Antioxidants in the Context of In Silico Predictors.Antioxidants (Basel, Switzerland) · 2025Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundXanthine oxidase inhibitors (XOI), classified as purine-like (allopurinol and oxypurinol) and non-purine (febuxostat and topiroxostat) XOI, present antioxidant properties by reducing the production of reactive oxygen species derived from purine metabolism. Oxidative stress is an important factor related to endothelial dysfunction and ischemia-reperfusion injury, and may be implicated in the pathogenesis of heart failure, hypertension, and ischemic heart disease. However, there is contradictory evidence regarding the possible cardiovascular (CV) protective effect exerted by XOI. Our objective is to compare the incidence of major adverse cardiovascular events (MACE), mortality, total (TCE) and specific CV events in randomized controlled trials (RCTs) testing XOI against placebo or no treatment.
methodsPubMed, EMBASE, Web of Science, Cochrane Central, Lilacs databases were searched from inception to Dec 30 2016, along with hand searching. RCTs including exclusively adult individuals, lasting ≥ 4 weeks, with no language restriction, were eligible. Independent paired researchers selected studies and extracted data. Considering the expected rarity of events, Peto and DerSimonian/Laird odds ratios (OR), the latter in case of heterogeneity, were used for analysis. Random-effects meta-regression was used to explore heterogeneity.
resultsThe analysis of MACE included 81 articles (10,684 patients, 6434 patient-years). XOI did not significantly reduce risk of MACE (OR
conclusionsPurine-like XOI may reduce the incidence of adverse CV outcomes. However, higher doses of allopurinol (> 300 mg/day) may be associated with loss of CV protection.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.