Effect of febuxostat on left ventricular diastolic function in patients with asymptomatic hyperuricemia: a sub analysis of the PRIZE Study
Authors: Kusunose Kenya , Yoshida Hisako , Tanaka Atsushi , Teragawa Hiroki , Akasaki Yuichi , Fukumoto Yoshihiro , Eguchi Kazuo , Kamiya Haruo , Kario Kazuomi , Yamada Hirotsugu , Sata Masataka , Node Koichi ,   The PRIZE Study Investigators,   Principal Investigator, Node Koichi ,   PRIZE Steering Committee, Murohara Toyoaki , Inoue Teruo , Sata Masataka , Ohishi Mitsuru ,   PRIZE Executive Committee, Yokote Kotaro , Kario Kazuomi , Watada Hirotaka , Shimomura Iichiro , Matsuhisa Munehide , Fukumoto Yoshihiro , Maemura Koji , Ohya Yusuke ,   PRIZE Site Investigators, Akasaki Yuichi , Ako Junya , Amano Hirohisa , Aonuma Kazutaka , Aoyama Yutaka , Arai Hirofumi , Asai Kuniya , Asaka Machiko , Awaji Yoshifumi , Ban Noriko , Ban Toshiaki , Bando Yasuko K. , Daida Hiroyuki , Eguchi Shunsuke , Enomoto Mami , Fujii Yuichi , Fujikake Akinori , Fujimoto Masanori , Fujisaka Tomohiro , Fujita Shuichi , Fukae Satoki , Fukuda Daiju , Fukui Mieko , Goriki Yuhei , Hamasaki Shuichi , Hara Tomoya , Hasegawa Hiroshi , Hashimoto Kenichi , Hata Mitsumasa , Hata Shiro , Hayashida Ryo , Higashi Akihiro , Higuchi Seiichiro , Honda Akihiro , Hoshide Satoshi , Hoshiga Masaaki , Hotchi Junko , Igata Sachiyo , Ikehara Yumi , Inoue Youhei , Ishigami Hiroko , Ishihara Masaharu , Ishii Hideki , Ishikawa Tetsuya , Ishimatsu Takashi , Ishiyama Yusuke , Ito Takahide , Ito Ayumi , Kadokami Toshiaki , Kamiya Haruo , Kashihara Soichiro , Kawamura Yoshihiro , Kitagawa Kazuo , Kobayashi Yoshio , Kodera Satoshi , Koga Seiji , Koide Hisashi , Koide Yuji , Koiwaya Hiroshi , Kojima Hiroki , Komai Eri , Komatsu Takaaki , Kono Shingo , Kono Takashi , Kubota Yoshiaki , Kuroda Akio , Kuroyanagi Takanori , Kushiyama Akifumi , Kusunose Kenya , Maruhashi Tatsuya , Matsunaga Kazuo , Matsuura Tomomi , Mayama Takafumi , Mine Daigo , Miyamura Masatoshi , Morimoto Ryota , Morita Hideaki , Nagano Hidekazu , Nakagawa Hidemitsu , Nakamura Katsunori , Nakamura Ryo , Nakamura Ikuko , Nakashima Hitoshi , Nanasato Mamoru , Nishi Isao , Niwano Shinichi , Nomura Shuichi , Oda Nozomu , Oguchi Shio , Oguri Mitsutoshi , Okahara Arihide , Okutsu Masaaki , Ozaki Fumitake , Ozeki Michishige , Saisu Tomoko , Saito Yuichi , Saitoh Makoto , Saka Yosuke , Sakai Yoshihiko , Sakane Kazushi , Sakuma Ikki , Sandeep Shakya , Sano Hiroaki , Sekino Hisakuni , Senoo Yuka , Shibata Kensaku , Shibata Yoshisato , Shibata Takahisa , Shiga Akina , Shiina Kazuki , Shimabukuro Michio , Shimbo Yusaku , Shimizu Wataru , Shimpo Masahisa , Soeki Takeshi , Sohmiya Koichi , Suzuki Hiroyuki , Suzuki Susumu , Suzuki Makoto , Tahara Nobuhiro , Tahara Tazu , Takahashi Sadako , Takase Bonpei , Takegami Kaoru , Takiguchi Tomoko , Takikawa Tomonobu , Tamura Ai , Tanaka Tomoaki , Tanaka Akihito , Tanaka Hiroyuki , Tanigawa Jun , Tanimura Daisuke , Tatami Yosuke , Terano Takashi , Terasaki Fumio , Tobushi Tomoyuki , Tokoi Seiko , Tsubouchi Toshiyuki , Uchida Daigaku , Ueda Tomohiro , Ueno Rie , Ueno Hiromi , Ueyama Chikara , Wakatsuki Tetsuzo , Watanabe Tomohiko , Watarai Masato , Yaguchi Isao , Yajima Ayumu , Yamada Jiko , Yamamoto Kyohei , Yamauchi Sachiko , Yamauchi Yohei , Yokota Naoto , Yoshida Tomohikov , Yoshioka Goro ,   Members of the Data and Safety Monitoring Board, Ako Junya , Kitagawa Kazuo ,   Members of the Clinical Events Committee, Shimizu Wataru , Ishihara Masaharu ,   Imaging Core Laboratory, Ishizu Tomoko ,   Monitoring, Ueda Shinichiro ,   Trial Secretvariat, Tanaka Atsushi , Oyama Jun-ichi , Kagiyama Mikiko 
Published: October 2021

Hyperuricemia is related to an increased risk of cardiovascular events from a meta-analysis and antihyperuricemia agents may influence to cardiac function. We evaluated the effect of febuxostat on echocardiographic parameters of diastolic function in patients with asymptomatic hyperuricemia as a prespecified endpoint in the subanalysis of the PRIZE study. Patients in the PRIZE study were assigned randomly to either add-on febuxostat treatment group or control group with only appropriate lifestyle modification. Of the 514 patients in the overall study, 65 patients (31 in the febuxostat group and 34 in the control group) who had complete follow-up echocardiographic data of the ratio of peak early diastolic transmitral flow velocity (E) to peak early diastolic mitral annular velocity (e′) at baseline and after 12 and 24 months were included. The primary endpoint was a comparison of the changes in the E/e′ between the two groups from baseline to 24 months. Interestingly, e′ was slightly decreased in the control group compared with in the febuxostat group (treatment p = 0.068, time, p = 0.337, treatment × Time, p = 0.217). As a result, there were significant increases in E/e′ (treatment p = 0.045, time, p = 0.177, treatment × time, p = 0.137) after 24 months in the control group compared with the febuxostat group. There was no significant difference in the serum levels of N-terminal-pro brain natriuretic peptide and high-sensitive troponin I between the two groups during the study period. In conclusions, additional febuxostat treatment in patients with asymptomatic hyperuricemia for 24 months might have a potential of preventable effects on the impaired diastolic dysfunction.