Pretreatment with antioxidants and allopurinol diminishes cardiac onset events in coronary artery bypass grafting

Sisto, Tero; Paajanen, Hannu; Metsä‐Ketelä, T.; Harmoinen, Aimo; Nordback, Isto; Tarkka, Matti

doi:10.1016/0003-4975(95)00197-s

Cited by 85 publications

(49 citation statements)

References 22 publications

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“…In humans, allopurinol has been investigated in coronary artery bypass graft surgery, where it has reduced ischemic events, produced less ST-T segment depression, and lowered the use of postoperative inotropic support. 27 This is supported by other reports 7,28,29 but not by all. 30 More recently, Cardillo et al 9 demonstrated an improvement in forearm endothelial function in hypercholesterolemic subjects after an infusion of intra-arterial oxypurinol.…”

Section: Discussionsupporting

confidence: 81%

Allopurinol Normalizes Endothelial Dysfunction in Type 2 Diabetics With Mild Hypertension

et al. 2000

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Abstract-Therapeutic strategies against free radicals have mostly focused on the augmentation of antioxidant defenses (eg, vitamins C and E). A novel approach is to prevent free radical generation by the enzyme system xanthine oxidase. We examined whether the inhibition of xanthine oxidase with allopurinol can improve endothelial function in subjects with type 2 diabetes and coexisting mild hypertension compared with control subjects of a similar age. We examined 23 subjects (11 patients with type 2 diabetes and 12 healthy age-matched control subjects) in 2 parallel groups. The subjects were administered 300 mg allopurinol in a randomized, placebo-controlled study in which both therapies were administered for 1 month. Endothelial function was assessed with bilateral venous occlusion plethysmography, in which the forearm blood flow responses to intra-arterial infusions of endothelium-dependent and -independent vasodilators were measured. Allopurinol significantly increased the mean forearm blood flow response to acetylcholine by 30% (3.16Ϯ1.21 versus 2.54Ϯ0.76 mL ⅐ 100 mL Ϫ1 ⅐ min Ϫ1 allopurinol versus placebo; Pϭ0.012, 95% CI 0.14, 1.30) but did not affect the nitroprusside response in patients with type 2 diabetes. There was no significant impact on either endothelium-dependent or -independent vascular responses in age-matched control subjects. Allopurinol improved endothelial function to near-normal levels. Regarding markers of free radical activity, the level of malondialdehyde was significantly reduced (0.30Ϯ0.04 versus 0.34Ϯ0.05 mol/L for allopurinol versus placebo, Pϭ0.03) in patients with type 2 diabetes but not in control subjects. The xanthine oxidase inhibitor allopurinol improves endothelial dysfunction in patients with type 2 diabetes with mild hypertension but not in matched control subjects. In the former group, allopurinol restored endothelial function to near-normal levels.

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Section: Discussionsupporting

confidence: 81%

Allopurinol Normalizes Endothelial Dysfunction in Type 2 Diabetics With Mild Hypertension

et al. 2000

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“…In addition, CPK-MB and lactate dehydrogenase (LDH) levels were lower in these patients, which may offer some protection for cardiac muscle. Sisto et al 16 also reported that post-operative CPK-MB levels decreased following administration of antioxidants such as allopurinol and vitamin C in patients undergoing coronary bypass surgery, describing cardioprotective effects based on their findings. In the present study, CPK-MB levels were lower -but not significantly so -8 h post-operatively in the VC group, although troponin I levels had decreased significantly.…”

Section: Discussionmentioning

confidence: 99%

Effect of High-Dose Vitamin C on Oxygen Free Radical Production and Myocardial Enzyme after Tourniquet Ischaemia–Reperfusion Injury during Bilateral Total Knee Replacement

2010

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This study investigated the effects of highdose vitamin C on oxygen free radical production and cardiac enzymes after tourniquet application and ischaemiareperfusion injury during bilateral total knee replacement (TKR) in elderly patients. In the vitamin C (VC) group (VC group, n = 16), during surgery, patients received a priming bolus of 0.06 g/kg vitamin C with 100 ml saline followed by 0.02 g/kg vitamin C mixed with 30 ml saline, intravenously. The control group (n = 16) received no intra-operative vitamin C. In the VC group, malondialdehyde levels were lower, and arterial oxygen tension and mean blood pressure were higher, than in controls after post-operative deflation of both knee tourniquets. Troponin I levels were lower in the VC group than in controls 8 h postoperation.Administering high-dose vitamin C during bilateral TKR could prevent oxygen free radical production and a decline in arterial oxygen tension and mean blood pressure induced by ischaemia-reperfusion injury, thereby protecting the myocardium.

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“…Finally, it should be mentioned that several animal and clinical studies suggest that antioxidant administration might be an attractive approach to attenuate extensive oxidative attack within vital organs (Sisto et al 1995;Metin et al 2002;Liu et al 2004;Kanter et al 2005).…”

Section: Discussionmentioning

confidence: 99%

Persistent Oxidative Stress after Myocardial Infarction Treated by Percutaneous Coronary Intervention

Nikolić-Heitzler

Rabuzin

Tatzber

et al. 2006

Tohoku J. Exp. Med.

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[247][248][249][250][251][252][253][254][255] Acute myocardial infarction causing cardiac ischemia is responsible for the majority of cardiac related deaths. Medical interventions that ensure rapid reperfusion, such as percutaneous coronary intervention, are aimed to allow myocardial re-oxygenation. However, this generates reactive oxygen species, resembling ischemiareperfusion type of injury based on oxidative stress. In the present study we monitored dynamic changes of total serum peroxides, total antioxidant capacity and soluble intercellular adhesion molecule-1 as well as the titer of antibodies against oxidized low-density lipoproteins in the blood during the convalescence period of 32 patients with acute myocardial infarction treated by percutaneous coronary intervention. Samples were taken at admittance and at two hours, four hours, three days and seven days following percutaneous coronary intervention. Total antioxidant capacity dropped to 82% ( p < 0.05). The titer of antibodies against oxidized low-density lipoproteins transiently decreased within the first three days, and increased afterwards. The values of serum peroxides and soluble intercellular adhesion molecule-1 increased continuously in respect to the initial levels reaching the maximum at the time of release from hospital. These findings indicate a persistent oxidative stress that might be associated with intravascular inflammation in patients during convalescence and release from hospital. myocardial infarction; percutaneous coronary intervention; inflammation; soluble intercellular adhesion molecule-1; lipid peroxidation © 2006 Tohoku University Medical Press While oxidative stress has been shown to be related with the age and living habits (Ozbay and Dulker 2002), it plays an important role in the development of vascular diseases that affect vital organs, in particular brain and heart (Zarkovic 2003;Zarkovic et al. 2004;Madamanchi et al.

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Pretreatment with antioxidants and allopurinol diminishes cardiac onset events in coronary artery bypass grafting

Cited by 85 publications

References 22 publications

Allopurinol Normalizes Endothelial Dysfunction in Type 2 Diabetics With Mild Hypertension

Allopurinol Normalizes Endothelial Dysfunction in Type 2 Diabetics With Mild Hypertension

Effect of High-Dose Vitamin C on Oxygen Free Radical Production and Myocardial Enzyme after Tourniquet Ischaemia–Reperfusion Injury during Bilateral Total Knee Replacement

Persistent Oxidative Stress after Myocardial Infarction Treated by Percutaneous Coronary Intervention

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