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Allopurinol fails to improve heart disease outcomes

https://doi.org/10.1136/dtb.2025.000021

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    Key learning points

    • The ALL-HEART study compared the effect of allopurinol with usual care on a composite cardiovascular outcome in people with ischaemic heart disease (IHD) who did not have gout.

    • There was no difference between the groups in cardiovascular outcomes, death or health-related quality of life after nearly 5 years of follow-up.

    • Allopurinol is not recommended for the secondary prevention of cardiovascular events in people with IHD who do not have gout.

    A randomised clinical trial found no benefit of allopurinol on cardiovascular outcomes or health-related quality of life in patients with ischaemic heart disease who did not have gout.1

    Overview

    The ALL-HEART prospective randomised open-label blinded endpoint study tested whether allopurinol added to usual care could improve cardiovascular outcomes in patients aged ≥60 years with ischaemic heart disease (IHD) but who did not have gout.1 Participants were eligible if they had a history of IHD (myocardial infarction [MI], angina or other evidence of IHD). Exclusion criteria included …

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    Footnotes

    • Contributors DTB Team.

    • Provenance and peer review Commissioned; internally peer reviewed.