The prognostic impact of allopurinol in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Serum uric acid: a forgotten prognostic marker in acute coronary syndromes?

“…However, in the context of myocardial infarction, only a very small randomized study in 60 patients submitted to primary PCI is available. 30 It showed a benefit with allopurinol therapy, with a reduction in myocardial necrosis extension as well as a 13% reduction in major acute coronary events at 30-day follow up. We tried to analyse this subject in the small group of patients with increased serum UA.…”

Gout Outcomes. Literature Review. Part Ii. Comorbid Diseases, Risk of Developing Cardiovascular Catastrophes and Death in Gout Patients

“…В плацебоконтролируемом исследовании 40 пациен-тов с ИМ с подъемом сегмента ST, перенесших оператив-ное вмешательство на коронарных артериях, дополни-тельный прием аллопуринола (100 мг/сут с последующим увеличением дозы до 400 мг/сут в течение 1 мес) в сравне-нии с плацебо приводил к уменьшению пика концентра-ции тропонина I и креатининфосфокиназы и более эффе-ктивному возврату к изолинии сегмента ST. Кроме того, у пациентов, получавших в течение месяца аллопуринол, отмечалось снижение на 13% числа случаев значительных сердечных cобытий в сравнении с плацебо [87]. Авторы считают, что, обладая способностью уменьшать потреб-ность миокарда в кислороде, аллопуринол может быть по-лезным у пациентов с ИБС.…”

Do We Need Another Look at Serum Uric Acid in Cardiovascular Disease? Serum Uric Acid as a Predictor of Outcomes in Acute Myocardial Infarction

“…In 2010, Rentoukas and colleagues (Rentoukas et al, 2010) reported on a small, single-center randomized controlled trial in Greece in which consecutive acute STEMI patients (June 2005 -June 2006) undergoing PCI within 3-12 hours post-symptom onset were randomized to receive allopurinol (n=21, 15 men, mean age 65 years) or placebo (n=19, 14 men, mean age 64 years) for 30 days. A loading dose of allopurinol (400 mg) was administered as soon as AMI was diagnosed, and treatment continued with 100 mg/day.…”

“…The small RCT of allopurinol in STEMI patients undergoing PCI is interesting in that indicates the potential of an intervention affecting the XO-SUA system in this setting (Rentoukas et al, 2010). The study from South Korea reporting on consecutive PCI patients (predominantly elective, but 25% also acute) is of interest as it indicates a possible element of mechanism(s) by which increased SUA, or a condition characterized by increased SUA (specifically, hyperuricemia), might influence AMI outcomes in subjects undergoing acute PCI (potential effects on the renal function).…”