The prognostic impact of allopurinol in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

Oxidative stress has been shown to increase after acute myocardial infarction and during coronary reperfusion. Allopurinol inhibits xanthine oxidase, an enzyme involved in reperfusion injury. In this study, 40 patients with ST elevation myocardial infarction and symptoms' onset 3-12 h, who underwent primary coronary intervention, were administered either allopurinol (loading dose 400 mg followed by 100 mg for 1 month--group A, 21 patients), or placebo (group B). Allopurinol resulted in a more effective ST-E recovery (P<0.05 for all comparisons) and lower peak values of troponin I (P=0.04), CPK (P=0.01) and CK-MB (P=0.03). After 1-month follow-up period, 13% lower incidence of major adverse cardiac events (P=0.002) was also observed in group A, whereas no significant differences in the EF were detected between the groups studied. In our study population, allopurinol administration was beneficial concerning tissue reperfusion, myocardial injury and clinical outcomes.