Document Type : Original Article
Authors
- Mohammad Kermani-Alghoraishi, MD 1
- Hamid Sanei 2
- Kiyan Heshmat-Ghahdarijani 3
- Rahil Ghahramani 4
- Mehrdad Honarvar 5
- Masoumeh Sadeghi, MD 6
1 Associate Professor, Fellowship of Interventional Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
4 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
5 Cardiology Department, Bendigo Hospital, Bendigo, Victoria, Australia
6 Associated Professor of Cardiology, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan,
Abstract
Background: The reactive oxygen species generation which induces with activation of xanthine oxidase (XO) enzymatic system is one of the main causes of ischemia-reperfusion injury for an ischemic heart. Allopurinol, as a XO inhibitor, has an inhibitory role on free radical productions in ST-elevation myocardial infarction (STEMI) patients. The aim of this study is to evaluate impact of allopurinol pre-treatment on post-revascularization outcomes in patients who admitted in STEMI.
Methods: Ninety patients with acute STEMI were enrolled in this randomized double blind clinical trial and divided to in two equal groups. Allopurinol group received 600 mg allopurinol loading dose before the emergency PCI and the control group received the placebo medication in a same shape. Thrombolysis in Myocardial Infarction (TIMI) flow, ECG changes, troponin level and major cardiac events (MACE) occurrence during 1 month follow up were assessed.
Results: Finally, 81 patients were analyzed. Mean age of patients was 59.52(11.31) and 61.3(9.25) in allopurinol and control groups respectively (p = 0.49). Troponin level 48 hour after the PCI and ST-elevation regression had not significant difference between the groups [(p = 0.25) and (p = 0.21) respectively]. TIMI flow had improved in allopurinol group rather than placebo (p = 0.02). PCI success rate was 78.6% and 61.5% in case and control group respectively (p = 0.09). MACE and other clinically outcomes were similar between groups (p > 0.05).
Conclusions: This study revealed that allopurinol pre-treatment could improve TIMI flow in the patients undergoing primary or rescue PCI in acute STEMI setting.
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