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European Journal of Cardio-Thoracic Surgery, Vol 4, 538-542, Copyright © 1990 by European Association for Cardio-thoracic Surgery

ARTICLES

Protective influence of pretreatment with allopurinol on myocardial function in patients undergoing coronary artery surgery

A Bochenek, Z Religa, TJ Spyt, K Mistarz, A Bochenek, M Zembala and H Gryzbek
University Department of Cardiac Surgery, Silesian Medical Academy, Katowice, Poland.

Xanthine oxidase is responsible for the release of free oxygen radicals during myocardial reperfusion. Allopurinol was shown to be an effective inhibitor of this reaction in the laboratory experiments, but not in patients. Thirteen male patients undergoing routine coronary artery bypass graft surgery were treated with allopurinol in doses of 15 mg/kg per day for 4 days before the operation. Haemodynamic function in the early period after cardiopulmonary bypass, ECG, enzyme release and ultrastructural findings in this group were compared with those in a control group of 13 male patients matched for age distribution and stage of coronary disease. Left ventricular stroke work index was higher in the treatment group 10 min (P less than 0.001) and 15 min after termination of cardiopulmonary bypass (P less than 0.01) and also 2 h later (P less than 0.02). In the early post-operative recovery phase fewer episodes of arrhythmia were observed in this group of patients (P less than 0.001). Electron microscopy studies of the myocardium and CK and CK-MB release showed no significant differences between groups. Thus, allopurinol may have a protective effect on the human ischaemic myocardium in the early period of reperfusion.

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