Uric acid and xanthine oxidase in heart failure - Emerging data and therapeutic implications

Wolfram Doehner, Ewa A. Jankowska, Jochen Springer, Mitja Lainscak, Stefan D. Anker

Research output: Contribution to journalArticlepeer-review

Abstract

The role of hyperuricaemia as cardiovascular risk factor has exhaustingly been debated for decades. While the association of elevated uric acid (UA) levels with increased mortality risk as convincingly been shown, the question whether UA is independently predictive of just a related effect within a more complex risk factor profile (including metabolic, inflammatory and haemodynamic risk factors) is still a matter of dispute. In heart failure the independent prognostic and functional impact of elevated UA has not only been shown but also the pathophysiologic mechanism(s) and the potential of targeted therapeutic interventions have been investigated in some detail. The emerging picture suggests the increased activity of the enzyme xanthine oxidase (XO) with corresponding increased production of free oxygen radical (ROS) as a main underlying principle with the resulting increase in UA levels being mostly a marker of this up-regulated pathway. While this concept will not diminish the value of UA as a prognostic marker, it provides the basis for a novel metabolic treatment option and the means to identify those patients most eligible for this tailored therapy. This review will summarize the recent evidence on XO as a novel and promising therapeutic target in heart failure.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - Jul 27 2015

Keywords

  • Cachexia
  • Ischemic stroke
  • MCAO model
  • Muscle
  • Sarcopenia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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