title: Clinical Study on efficacy of allopurinol in patients with acute coronary syndrome and its functional mechanism.
abstract: OBJECTIVE
  To investigate the therapeutic effect of allopurinol treatment on acute coronary syndrome and to elucidate its possible mechanism.
  
  
  METHODS
  Patients with acute coronary syndrome (n = 100) were recruited as research subjects in our hospital. The patients were randomly divided into two groups, an allopurinol group (n = 50) and a control group (n = 50). These two groups were treated with conventional antiplatelet, anticoagulation and anti-ischemic therapy; allopurinol therapy was added to the allopurinol group based on conventional treatment indications. Biochemical markers such as serum creatinine, uric acid, BNP, blood glucose and blood lipid were compared between the two groups. Indicators of oxidative stress and inflammatory response (MDA, OX-LDL, NO, hs-CRP and TNF-α), as well as cardiovascular events during 2-years follow-up, were recorded.
  
  
  RESULTS
  On admission, there was no difference in serum creatinine, uric acid, BNP, blood glucose or lipid levels between the two groups (P > 0.05). However, after 1 month of treatment, these levels were improved in patients in the allopurinol group compared to the control group (P < 0.05). MDA, OX-LDL, hs-CRP and TNF-α decreased after treatment periods of 14 days and 1 month. They were also decreased at 3 month, 6 month, 1 year, and 2 year follow-up visits. However, data from the allopurinol group demonstrated significantly lower levels than in the control group (P < 0.05). Additionally, compared with the control group, allopurinol treatment significantly elevated the level of NO (P < 0.05). The total effective rates of the allopurinol group are much higher than in the control group for both angina pectoris (93.2% and 76%, respectively) and ECG (96% and 82%, respectively). Most patients in the allopurinol group (n = 40) and the control group (n = 41) received stent implantation with no significant difference shown between them. The incidence of cardiovascular events during 2 years of follow-up in the allopurinol group was 10%; it was 30% in the control group.
  
  
  CONCLUSIONS
  Allopurinol has a remarkable effect in the treatment of ACS and can improve the oxidative stress and inflammatory reaction indicators of patients. The protective mechanism of allopurinol might be achieved by suppressing the secretion and release of inflammatory mediators such as TNF-α, hs-CRP, OX-LDL and MDA while increasing levels of NO.
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China. Electronic address: sunllmm2007@126.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China.
authors.forename: Chunya
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China.
authors.forename: Huanhua
authors.initials: H
authors.lastname: Du
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China.
authors.forename: Kangjian
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Pudong New Area People's Hospital, ShangHai, 201200, PR China. Electronic address: zep941@163.com.
authors.forename: Daifu
authors.initials: D
authors.lastname: Zhang
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D000493:Allopurinol / Q000008:administration & dosage*; D000963:Antimetabolites / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000963:Antimetabolites; D015415:Biomarkers; D000493:Allopurinol
keywords: Acute coronary syndrome; Allopurinol; Cardiovascular events; Clinical efficacy