159 ALLOPURINOL REDUCES LEFT VENTRICULAR MASS IN PATIENTS WITH TYPE 2 DIABETES AND LEFT VENTRICULAR HYPERTROPHY

Abstract

{OBJECTIVES}: This study sought to ascertain whether high-dose allopurinol causes regression of left ventricular mass ({LVM}) in patients with type 2 diabetes mellitus (T2DM). {BACKGROUND}: Left ventricular hypertrophy ({LVH}) is common in T2DM and contributes to patients' high cardiovascular ({CV}) event rate. Oxidative stress ({OS}) has been implicated in {LVH} development, and allopurinol has been previously shown to reduce vascular {OS}. We therefore investigated whether allopurinol causes regression of {LVH} in patients with T2DM. {METHODS}: We conducted a randomized, double-blind, placebo-controlled study of 66 optimally-treated T2DM patients with echocardiographic evidence of {LVH}. Allopurinol, 600 mg/day, or placebo was given over the study period of 9 months. The primary outcome was reduction in {LVM} as calculated by cardiac magnetic resonance imaging at baseline and at 9 months' follow-up. Secondary endpoints were change in flow-mediated dilation and augmentation index. {RESULTS}: Allopurinol significantly reduced absolute {LVM} (-2.65 + 5.91 g vs. placebo group +1.21 + 5.10 g [p = 0.012]) and {LVM} indexed to body surface area (-1.32 + 2.84 g/m(2) vs. placebo group +0.65 + 3.07 g/m(2) [p = 0.017]). No significant changes were seen in either flow-mediated dilation or augmentation index. {CONCLUSIONS}: Allopurinol causes regression of {LVM} in patients with T2DM and {LVH}. Regression of {LVH} has been shown previously to improve {CV} mortality and morbidity. Therefore, allopurinol therapy may become useful to reduce {CV} events in T2DM patients with {LVH}. (Allopurinol in Patients with Diabetes and {LVH}; {UKCRN} 8766). Copyright 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.