[HSF] Allopurinol references

[hgrmd at aol.com]

Sherman,
  Thanks for the info.  Guess I'll start using it.  Atleast they won't get gout!
Hal 
 
 
-----Original Message-----
From: turnages at mac.com
To: openheart-l at lists.hsforum.com
Sent: Mon, 22 Jan 2007 3:10 PM
Subject: [HSF] Allopurinol references


Hal, et al., 
 
Here are references describing prospective randomized trials with allopurinol in cardiac surgical patients. 
 
Castelli P, et al. J Cardiovasc Pharmacol, 1995, 25(1):119-25. 33 pts randomized to allopurinol vs. control. Allopurinol group had better recovery of cardiac output postop. 
 
Bochenek A, et al. Eur J Cardiothorac Surg, 1990, 4(10):538-42. 26 pts randomized to allopurinol vs. control. Improved left ventricular stroke work up to 2 hrs post CPB. 
 
Movahed A, et. al. Can J Cardiol. 1996, 12(2):138-44. 36 pts in randomized trial of allopurinol. Decreased level of lipid peroxidase byproducts and CK-MB in the allopurinol group after crossclamp release. 
 
Coghlan JG, et al. J Thorac Cardiovasc Surg. 1994, 107(1): 248-56. 20 pts randomized. Cardiac index improved quicker postop in the treatment group. 
 
To be fair, there is one study that shows a lack of benefit of allopurinol. However, this study like some of those above primarily looked at cardiac enzyme release. I think enzyme levels are probably relatively insensitive markers of the oxidative stress allopurinol decreases. Anyway, hope the above provides some scientific rationale for our use of allopurinol. As Prasanna said, we see it as just one component of minimizing inflammatory insult to the myocardium. 
 
W. Sherman Turnage, MD 
Lighthouse Anesthesiology Consultants, PL 
St. Augustine, FL 
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