Document Detail


Effect of allopurinol pretreatment on free radical generation after primary coronary angioplasty for acute myocardial infarction.
MedLine Citation:
PMID:  12717099     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Allopurinol, an inhibitor of xanthine oxidase, was shown to improve the regional ventricular function after coronary artery occlusion and reperfusion in animal models. The effects of oral administration of allopurinol on a transient increase in free radical generation after primary percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) and on their clinical outcomes were examined. Thirty-eight AMI patients undergoing primary PTCA were randomly assigned to control (group 1, n = 20) and allopurinol treatment groups (group 2, n = 18). Allopurinol (400 mg) was administered orally just after the admission (approximately 60 min before reperfusion). Free radical production was assessed by successive measurement of urinary excretion of 8-epi-prostaglandin F(2alpha) (PGF(2alpha)) after PTCA. Urinary 8-epi-PGF(2alpha) excretion was increased by twofold at 60-90 min after PTCA compared with the baseline value in group 1. This increase was completely inhibited in group 2. Plasma allopurinol concentration was 1,146 +/- 55 ng/ml in group 2 when reperfusion was achieved. Slow flow in the recanalized coronary artery after PTCA occurred less frequently in group 2 than in group 1. Cardiac index determined just after reperfusion and left ventricular ejection fraction at 6 months after PTCA were both significantly greater in group 2 than in group 1 although pulmonary capillary wedge pressure was similar in the two groups. In conclusion, allopurinol pretreatment is effective in inhibiting generation of oxygen-derived radicals during reperfusion therapy and the recovery of left ventricular function in humans.
Authors:
Weiping Guan; Tomohiro Osanai; Takaatsu Kamada; Hiroyuki Hanada; Hiroshi Ishizaka; Hiroyuki Onodera; Atsushi Iwasa; Norio Fujita; Shigeaki Kudo; Tadashi Ohkubo; Ken Okumura
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  41     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-28     Completed Date:  2004-03-18     Revised Date:  2004-12-03    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  699-705     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Allopurinol / administration & dosage,  blood,  therapeutic use*
Angioplasty, Transluminal, Percutaneous Coronary*
Dinoprost* / analogs & derivatives*
Electrocardiography
F2-Isoprostanes / urine
Female
Free Radical Scavengers / administration & dosage,  blood,  therapeutic use*
Free Radicals / metabolism
Humans
Male
Middle Aged
Myocardial Infarction / complications,  metabolism,  therapy*
Myocardial Reperfusion Injury / drug therapy,  etiology,  metabolism
Oxypurinol / blood
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/F2-Isoprostanes; 0/Free Radical Scavengers; 0/Free Radicals; 2465-59-0/Oxypurinol; 27415-26-5/8-epi-prostaglandin F2alpha; 315-30-0/Allopurinol; 551-11-1/Dinoprost

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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