Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism

Objective: To investigate the therapeutic effect of allopurinol treatment on acute coronary syndrome and to elucidate its possible mechanism. Methods: Patients with acute coronary syndrome (n = 100) were recruited as research subjects in our hospital. The patients were randomly divided into two grou...

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Main Authors: Ying Huang, Chunya Zhang, Zhiqing Xu, Jinghua Shen, Xiaogang Zhang, Huanhua Du, Kangjian Zhang, Daifu Zhang
Format: Article
Language:English
Published: Elsevier 2017-09-01
Series:Hellenic Journal of Cardiology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1109966616303190
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author Ying Huang
Chunya Zhang
Zhiqing Xu
Jinghua Shen
Xiaogang Zhang
Huanhua Du
Kangjian Zhang
Daifu Zhang
author_facet Ying Huang
Chunya Zhang
Zhiqing Xu
Jinghua Shen
Xiaogang Zhang
Huanhua Du
Kangjian Zhang
Daifu Zhang
author_sort Ying Huang
collection DOAJ
description Objective: To investigate the therapeutic effect of allopurinol treatment on acute coronary syndrome and to elucidate its possible mechanism. Methods: Patients with acute coronary syndrome (n = 100) were recruited as research subjects in our hospital. The patients were randomly divided into two groups, an allopurinol group (n = 50) and a control group (n = 50). These two groups were treated with conventional antiplatelet, anticoagulation and anti-ischemic therapy; allopurinol therapy was added to the allopurinol group based on conventional treatment indications. Biochemical markers such as serum creatinine, uric acid, BNP, blood glucose and blood lipid were compared between the two groups. Indicators of oxidative stress and inflammatory response (MDA, OX-LDL, NO, hs-CRP and TNF-α), as well as cardiovascular events during 2-years follow-up, were recorded. Results: On admission, there was no difference in serum creatinine, uric acid, BNP, blood glucose or lipid levels between the two groups (P > 0.05). However, after 1 month of treatment, these levels were improved in patients in the allopurinol group compared to the control group (P < 0.05). MDA, OX-LDL, hs-CRP and TNF-α decreased after treatment periods of 14 days and 1 month. They were also decreased at 3 month, 6 month, 1 year, and 2 year follow-up visits. However, data from the allopurinol group demonstrated significantly lower levels than in the control group (P < 0.05). Additionally, compared with the control group, allopurinol treatment significantly elevated the level of NO (P < 0.05). The total effective rates of the allopurinol group are much higher than in the control group for both angina pectoris (93.2% and 76%, respectively) and ECG (96% and 82%, respectively). Most patients in the allopurinol group (n = 40) and the control group (n = 41) received stent implantation with no significant difference shown between them. The incidence of cardiovascular events during 2 years of follow-up in the allopurinol group was 10%; it was 30% in the control group. Conclusion: Allopurinol has a remarkable effect in the treatment of ACS and can improve the oxidative stress and inflammatory reaction indicators of patients. The protective mechanism of allopurinol might be achieved by suppressing the secretion and release of inflammatory mediators such as TNF-α, hs-CRP, OX-LDL and MDA while increasing levels of NO.
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spelling doaj.art-b6693f64064c4cbc981c4ea40b6912f42022-12-22T01:33:15ZengElsevierHellenic Journal of Cardiology1109-96662017-09-0158536036510.1016/j.hjc.2017.01.004Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanismYing HuangChunya ZhangZhiqing XuJinghua ShenXiaogang ZhangHuanhua DuKangjian ZhangDaifu ZhangObjective: To investigate the therapeutic effect of allopurinol treatment on acute coronary syndrome and to elucidate its possible mechanism. Methods: Patients with acute coronary syndrome (n = 100) were recruited as research subjects in our hospital. The patients were randomly divided into two groups, an allopurinol group (n = 50) and a control group (n = 50). These two groups were treated with conventional antiplatelet, anticoagulation and anti-ischemic therapy; allopurinol therapy was added to the allopurinol group based on conventional treatment indications. Biochemical markers such as serum creatinine, uric acid, BNP, blood glucose and blood lipid were compared between the two groups. Indicators of oxidative stress and inflammatory response (MDA, OX-LDL, NO, hs-CRP and TNF-α), as well as cardiovascular events during 2-years follow-up, were recorded. Results: On admission, there was no difference in serum creatinine, uric acid, BNP, blood glucose or lipid levels between the two groups (P > 0.05). However, after 1 month of treatment, these levels were improved in patients in the allopurinol group compared to the control group (P < 0.05). MDA, OX-LDL, hs-CRP and TNF-α decreased after treatment periods of 14 days and 1 month. They were also decreased at 3 month, 6 month, 1 year, and 2 year follow-up visits. However, data from the allopurinol group demonstrated significantly lower levels than in the control group (P < 0.05). Additionally, compared with the control group, allopurinol treatment significantly elevated the level of NO (P < 0.05). The total effective rates of the allopurinol group are much higher than in the control group for both angina pectoris (93.2% and 76%, respectively) and ECG (96% and 82%, respectively). Most patients in the allopurinol group (n = 40) and the control group (n = 41) received stent implantation with no significant difference shown between them. The incidence of cardiovascular events during 2 years of follow-up in the allopurinol group was 10%; it was 30% in the control group. Conclusion: Allopurinol has a remarkable effect in the treatment of ACS and can improve the oxidative stress and inflammatory reaction indicators of patients. The protective mechanism of allopurinol might be achieved by suppressing the secretion and release of inflammatory mediators such as TNF-α, hs-CRP, OX-LDL and MDA while increasing levels of NO.http://www.sciencedirect.com/science/article/pii/S1109966616303190AllopurinolAcute coronary syndromeCardiovascular eventsClinical efficacy
spellingShingle Ying Huang
Chunya Zhang
Zhiqing Xu
Jinghua Shen
Xiaogang Zhang
Huanhua Du
Kangjian Zhang
Daifu Zhang
Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
Hellenic Journal of Cardiology
Allopurinol
Acute coronary syndrome
Cardiovascular events
Clinical efficacy
title Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
title_full Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
title_fullStr Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
title_full_unstemmed Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
title_short Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
title_sort clinical study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism
topic Allopurinol
Acute coronary syndrome
Cardiovascular events
Clinical efficacy
url http://www.sciencedirect.com/science/article/pii/S1109966616303190
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