Allopurinol as a cardioprotectant during coronary artery bypass graft surgery.
OBJECTIVE
To examine the role of allopurinol as a cardioprotectant during coronary artery bypass graft (CABG) surgery.


METHODS
A search of MEDLINE (1966-October 2002) was performed using the following terms: allopurinol, xanthine oxidase, oxygen free radical, and coronary artery bypass. References evaluated were limited to English-language and human studies, yielding 41 citations, 13 of which were found suitable. The 5 largest studies are discussed.


RESULTS
Multiple studies with various doses have evaluated the effects of allopurinol on outcomes in CABG patients. These studies found that allopurinol can reduce in hospital mortality, improve cardiac performance, reduce incidence of arrhythmias, reduce markers of ischemia and free-radical generation, and reduce the need for inotropic support. However, these findings were not consistent between all studies.


CONCLUSIONS
Allopurinol may reduce the incidence of CABG complications. Although the optimal dose has not been determined, reviewed literature suggests that patients should receive at least 600 mg one day prior to surgery, as well as at least 600 mg on the day of surgery.
Weimert
Nicole A
NA
School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705-2222, USA.
Tanke
William F
WF
Sims
J Jason
JJ
D000493:Allopurinol / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D017382:Reactive Oxygen Species / Q000378:metabolism
D016166:Free Radical Scavengers; D017382:Reactive Oxygen Species; D000493:Allopurinol