Allopurinol pretreatment improves postoperative recovery and reduces lipid peroxidation in patients undergoing coronary artery bypass grafting

J. G. Coghlan, W. D. Flitter, S. M. Clutton, R. Panda, R. Daly, G. Wright, C. D. Ilsley, T. F. Slater

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

In this prospective, randomized, double-blind, placebo-controlled study, the clinical, biochemical, and hemodynamic effects of xanthine oxidase inhibition in patients undergoing coronary artery bypass grafting were assessed. Allopurinol pretreatment significantly reduced the use of inotropic support after the operation (5 of 25 patients versus 13 of 25 patients, p < 0.01) and increased the rate of peripheral warming (11.4 ± 0.85 hours versus 14.4 ± 1 hours, p < 0.02). Twenty patients (9 in the allopurinol group and 11 in the placebo group) underwent invasive hemodynamic monitoring and intraoperative coronary sinus cannulation. The cardiac indexes of both groups were similar before the operation and for the first postoperative hour; thereafter, the cardiac index increased significantly in only the active treatment group (F = 3.33 and df = 5,90, p < 0.004). Products of lipid peroxidation (thiobarbituric acid reactive substances) increased significantly in only the placebo group, with increases being evident both in the systemic circulation (9.5 ± 3.2 nmol/gm albumin, p < 0.007, and 24 ± 5 nmol/gm albumin, p < 0.001, at 30 seconds and 2 minutes of reperfusion, respectively) and the coronary sinus (19.4 ± 5.8 nmol/gm albumin, p < 0.004, and 28 ± 4 nmol/gm albumin, p < 0.001, at 2 and 5 minutes of reperfusion, respectively. No significant difference was evident between the groups with respect to cardiac enzyme or vitamin E release. It is proposed that xanthine oxidase inhibition exerts its beneficial effects by reducing the level of free radical activity associated with reperfusion during coronary artery bypass grafting.

Original languageEnglish (US)
Pages (from-to)248-256
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume107
Issue number1
StatePublished - 1994
Externally publishedYes

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Allopurinol
Coronary Artery Bypass
Lipid Peroxidation
Albumins
Reperfusion
Coronary Sinus
Xanthine Oxidase
Placebos
Hemodynamics
Intraoperative Monitoring
Thiobarbituric Acid Reactive Substances
Vitamin E
Catheterization
Free Radicals
Enzymes
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Coghlan, J. G., Flitter, W. D., Clutton, S. M., Panda, R., Daly, R., Wright, G., ... Slater, T. F. (1994). Allopurinol pretreatment improves postoperative recovery and reduces lipid peroxidation in patients undergoing coronary artery bypass grafting. Journal of Thoracic and Cardiovascular Surgery, 107(1), 248-256.

Allopurinol pretreatment improves postoperative recovery and reduces lipid peroxidation in patients undergoing coronary artery bypass grafting. / Coghlan, J. G.; Flitter, W. D.; Clutton, S. M.; Panda, R.; Daly, R.; Wright, G.; Ilsley, C. D.; Slater, T. F.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 107, No. 1, 1994, p. 248-256.

Research output: Contribution to journalArticle

Coghlan, JG, Flitter, WD, Clutton, SM, Panda, R, Daly, R, Wright, G, Ilsley, CD & Slater, TF 1994, 'Allopurinol pretreatment improves postoperative recovery and reduces lipid peroxidation in patients undergoing coronary artery bypass grafting', Journal of Thoracic and Cardiovascular Surgery, vol. 107, no. 1, pp. 248-256.
Coghlan, J. G. ; Flitter, W. D. ; Clutton, S. M. ; Panda, R. ; Daly, R. ; Wright, G. ; Ilsley, C. D. ; Slater, T. F. / Allopurinol pretreatment improves postoperative recovery and reduces lipid peroxidation in patients undergoing coronary artery bypass grafting. In: Journal of Thoracic and Cardiovascular Surgery. 1994 ; Vol. 107, No. 1. pp. 248-256.
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AU - Ilsley, C. D.

AU - Slater, T. F.

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