Effect of allopurinol pretreatment on free radical generation after primary coronary angioplasty for acute myocardial infarction

J Cardiovasc Pharmacol. 2003 May;41(5):699-705. doi: 10.1097/00005344-200305000-00005.


Allopurinol, an inhibitor of xanthine oxidase, was shown to improve the regional ventricular function after coronary artery occlusion and reperfusion in animal models. The effects of oral administration of allopurinol on a transient increase in free radical generation after primary percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) and on their clinical outcomes were examined. Thirty-eight AMI patients undergoing primary PTCA were randomly assigned to control (group 1, n = 20) and allopurinol treatment groups (group 2, n = 18). Allopurinol (400 mg) was administered orally just after the admission (approximately 60 min before reperfusion). Free radical production was assessed by successive measurement of urinary excretion of 8-epi-prostaglandin F(2alpha) (PGF(2alpha)) after PTCA. Urinary 8-epi-PGF(2alpha) excretion was increased by twofold at 60-90 min after PTCA compared with the baseline value in group 1. This increase was completely inhibited in group 2. Plasma allopurinol concentration was 1,146 +/- 55 ng/ml in group 2 when reperfusion was achieved. Slow flow in the recanalized coronary artery after PTCA occurred less frequently in group 2 than in group 1. Cardiac index determined just after reperfusion and left ventricular ejection fraction at 6 months after PTCA were both significantly greater in group 2 than in group 1 although pulmonary capillary wedge pressure was similar in the two groups. In conclusion, allopurinol pretreatment is effective in inhibiting generation of oxygen-derived radicals during reperfusion therapy and the recovery of left ventricular function in humans.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Allopurinol / administration & dosage
  • Allopurinol / blood
  • Allopurinol / therapeutic use*
  • Angioplasty, Balloon, Coronary*
  • Dinoprost* / analogs & derivatives*
  • Electrocardiography
  • F2-Isoprostanes / urine
  • Female
  • Free Radical Scavengers / administration & dosage
  • Free Radical Scavengers / blood
  • Free Radical Scavengers / therapeutic use*
  • Free Radicals / metabolism
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Myocardial Infarction / metabolism
  • Myocardial Infarction / therapy*
  • Myocardial Reperfusion Injury / drug therapy
  • Myocardial Reperfusion Injury / etiology
  • Myocardial Reperfusion Injury / metabolism
  • Oxypurinol / blood
  • Ventricular Function, Left / drug effects


  • F2-Isoprostanes
  • Free Radical Scavengers
  • Free Radicals
  • 8-epi-prostaglandin F2alpha
  • Allopurinol
  • Dinoprost
  • Oxypurinol