Background: Although both of febuxostat and allopurinol are effective medicine for the treatment of patients with hyperuricemia, only a few reports have compared for hyperuricemic patients with heart failure (HF). This study was designed to compare the effect of them in patients with severe HF. Methods and Results: A total of 479 consecutive patients with categorized as New York Heart Association class 3 or 4 were retrospectively investigated. Of these patients, 202 were hyperuricemic at admission [8.0 mg/dL < uric acid (UA)] and 151 were administered antihyperuricemics after admission and divided into 2 groups (febuxostat, n = 61; allopurinol, n = 90). After 12 months of follow-up, the cardiac event-free rate in the febuxostat group was significantly higher than that in the allopurinol group (55.7% vs 41.1%; P < .05). Although the baseline characteristics such as the level of brain natriuretic peptide (BNP) and the left ventricular ejection fraction were similar between the 2 groups prior to the introduction of the antihyperuricemics, the percent changes of serum creatinine and BNP levels improved significantly in the febuxostat group than in the allopurinol group. Conclusion: Our data suggest that febuxostat prevents worsening renal function and shows favorable effects in patients with severe HF.
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