[HSF] Allopurinol

[Nasser F. Abou'Seada]

Hope it does help 

NFA

1: J Cardiovasc Pharmacol. 1995 Jan;25(1):119-25. Links 
Improvement of cardiac function by allopurinol in patients undergoing
cardiac surgery.Castelli P, Condemi AM, Brambillasca C, Fundaro P, Botta M,
Lemma M, Vanelli P, Santoli C, Gatti S, Riva E. 
Anesthesia and Intensive Care Unit, Ospedale Luigi Sacco, Italy.

Allopurinol reduces formation of cytotoxic free radicals during myocardial
ischemia/reperfusion in animals. To evaluate the effect of allopurinol on
cardiac performance and metabolism after coronary bypass in humans, we
divided 33 patients into two groups: 15 patients (controls) received no
allopurinol and 18 patients received 200 mg allopurinol intravenously (i.v.)
1 h preoperatively. Hemodynamic measurements were made with a triple-lumen
thermodilution pulmonary artery catheter before cardiopulmonary bypass
(CPB), 30 min after completion of CPB and 6 h later in the intensive care
unit (ICU). A catheter placed into the coronary sinus was used for blood
sampling for measurement of lactate and creatine phosphokinase MB.
Peripheral blood was obtained for measurement of xanthine oxidase activity
(XO), uric acid, and thiol groups. A myocardial biopsy was taken for
measurement of thiol group content and XO before CPB and after heparin
neutralization with protamin (a few minutes after CPB). Treated patients had
better recovery of cardiac output (CO) and left ventricular stroke work
(LVSW) 30 min and 6 h after completion of CPB than did controls. Allopurinol
significantly reduced plasma XO. Plasma concentrations of uric acid
increased significantly in both groups 30 min after completion of CPB, but
the increase in controls was greater (p < 0.02) than with allopurinol. Thiol
group levels increased (p < 0.05) only in controls. Our results demonstrate
improvement of cardiac function in coronary artery bypass surgery with
allopurinol that is related to its metabolic effects consistent with
protection against XO catalyzed free radical-mediated injury.

PMID: 7723340 [PubMed - indexed for MEDLINE]

NFA

> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com [mailto:openheart-l-
> bounces at lists.hsforum.com] On Behalf Of Hgrmd at aol.com
> Sent: Sunday, January 21, 2007 8:33 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [HSF] Allopurinol
> 
> Dear Sherman,
>   Where is the clinical evidence that allopurinol is of any benefit in
> treating intraop myocardial damage?  I assume it theoretically diminishes
> reperfusion damage.  Again, in the absence of blinded, randomized studies,
how do
> you
> know it does anything?
> Hal
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