Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery

Piero Castelli, Anna Maria Condemi, Claudio Brambillasca, Pino Fundarò, Mario Botta, Massimo Lemma, Paolo Vanelli, Carmine Santoli, Silvia Gatti, Emma Riva

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

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 preop-eratively. 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 prota-min (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.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalJournal of Cardiovascular Pharmacology
Volume25
Issue number1
Publication statusPublished - 1995

Fingerprint

Allopurinol
Thoracic Surgery
Cardiopulmonary Bypass
Xanthine Oxidase
Sulfhydryl Compounds
Uric Acid
Free Radicals
Catheters
Thermodilution
Myocardial Reperfusion
Coronary Sinus
Creatine Kinase
Coronary Artery Bypass
Cardiac Output
Pulmonary Artery
Myocardial Ischemia
Intensive Care Units
Heparin
Lactic Acid
Hemodynamics

Keywords

  • Allopurinol
  • Ischemia
  • Oxygen-free radicals
  • Reperfusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology

Cite this

Castelli, P., Maria Condemi, A., Brambillasca, C., Fundarò, P., Botta, M., Lemma, M., ... Riva, E. (1995). Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery. Journal of Cardiovascular Pharmacology, 25(1), 119-125.

Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery. / Castelli, Piero; Maria Condemi, Anna; Brambillasca, Claudio; Fundarò, Pino; Botta, Mario; Lemma, Massimo; Vanelli, Paolo; Santoli, Carmine; Gatti, Silvia; Riva, Emma.

In: Journal of Cardiovascular Pharmacology, Vol. 25, No. 1, 1995, p. 119-125.

Research output: Contribution to journalArticle

Castelli, P, Maria Condemi, A, Brambillasca, C, Fundarò, P, Botta, M, Lemma, M, Vanelli, P, Santoli, C, Gatti, S & Riva, E 1995, 'Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery', Journal of Cardiovascular Pharmacology, vol. 25, no. 1, pp. 119-125.
Castelli P, Maria Condemi A, Brambillasca C, Fundarò P, Botta M, Lemma M et al. Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery. Journal of Cardiovascular Pharmacology. 1995;25(1):119-125.
Castelli, Piero ; Maria Condemi, Anna ; Brambillasca, Claudio ; Fundarò, Pino ; Botta, Mario ; Lemma, Massimo ; Vanelli, Paolo ; Santoli, Carmine ; Gatti, Silvia ; Riva, Emma. / Improvement of cardiac function by allopurinol in patients undergoing cardiac surgery. In: Journal of Cardiovascular Pharmacology. 1995 ; Vol. 25, No. 1. pp. 119-125.
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