Mr. Tarkka et al., Effect of allopurinol on myocardial oxygen free radical production in coronary bypass surgery, SC CARDIOVA, 34(6), 2000, pp. 593-596
Objectives-Allopurinol protects the heart from reperfusion injury. The aim
of this study was to investigate myocardial free radical production during
reperfusion with and without allopurinol treatment in coronary artery bypas
s grafting patients randomized into allopurinol (n = 14) or placebo (n = 13
) groups.
Design-Allopurinol (1 g) was given blind prior to cardiopulmonary bypass an
d prior to opening the aorta. Oxygen free radicals were measured before ane
sthesia in arterial blood, before cross-clamping and I and 10 min after rep
erfusion in arterial and coronary sinus blood. Levels were measured as rela
tive concentrations by the electron spin resonance method.
Results-One minute after reperfusion the level of spin-trapped radicals in
arterial blood was elevated significantly (p = 0.016) in the allopurinol gr
oup, from 7.7 (SE:0.8) to 8.6 (1.4) and non-significantly (p = 0.074) in th
e placebo group, from 7.3 (0.7) to 8.3 (0.8). Ten minutes after reperfusion
the arterial values were 8.6 (1.5) in the allopurinol and 7.6 (0.7) in the
placebo group, the sinus values being 7.6 (1.3) and 8.3 (0.8), respectivel
y. Myocardial free radical production was -0.94 (1.21) in the allopurinol a
nd +0.79 (0.96) in the placebo group after 10 min reperfusion, the differen
ce being significant (p = 0.043),
Conclusions-All patients in both groups had an increasing tendency to free
radical production during early reperfusion, Patients treated with allopuri
nol showed less myocardial production of free radicals, indicating that its
protective effect may be due to its antioxidative properties.