Abstract 4517: High Dose Allopurinol is Anti-Ischaemic in Chronic Stable Angina
Background: Experimental evidence suggests that xanthine oxidase inhibitors (XOIs) can somehow reduce myocardial oxygen consumption for a given stroke volume. If such an effect also occurred in man, the possibility arises that XOIs could become a new anti-ischaemic agent in angina pectoris.
Aim: To investigate if allopurinol has anti-ischaemic effects in chronic stable angina
Methods: Sixty-five patients with stable chronic angina pectoris were recruited for a double blind, randomised, placebo controlled crossover study. They were randomised to receive either allopurinol (600 mg/day) or placebo for 6 weeks and then crossed over. Prior to randomisation and at the end of each treatment period, patients underwent an exercise tolerance test.
Results: Allopurinol significantly increased total exercise time, time to ST depression and time to symptoms compared to placebo (see table 1⇓). In addition, the systolic blood pressure at the end of the first stage of the Bruce protocol was significantly lower in the allopurinol arm (−6.1 mmHg) compared to placebo (−1.6 mmHg) (p=0.026). A higher heart rate and rate pressure product was achieved at peak exercise in the allopurinol arm compared to placebo.
Conclusion: In stable angina pectoris, high dose allopurinol has anti-ischaemic properties. Further research is needed to define the best place for high dose allopurinol in the overall management of angina pectoris.