European Journal of Biomedical and Pharmaceutical Sciences

ALLOPURINOL AS A PROMISING ANTI-ANGINAL AGENT: AN OLD DRUG WITH NEW INDICATION

Virendra Kushwaha, Dr. Varun Sharma*, Arti Lalchandani, Neeraj Kumar, Shaheen Saeed, Anand Narayan Singh, Santosh Kumar Barman, Sangeeta Agrawal,
Joginder Singh

ABSTRACT

Objective: To investigate protective role of Allopurinol (xantine oxidase inhibitor) in myocardial injury in patients with effort induced stable angina pectoris. Design: Prospective open label study. Setting: Tertiary care cardiac center. Patients: 14 Diagnosed cases of effort induced stable angina & 11 healthy volunteers for comparison. Interventions: Trade mill test (TMT) was performed in 14 patients of effort induced stable angina before allopurinol therapy and in 10 patients after two weeks allopurinol therapy (4 dropouts). Main outcome measures: Pre and post therapy total exercise duration, estimated maximum metabolic equivalents tasks (METs), % of target heart rate (THR) achieved and maximum ST depression. Pre and post therapy mean plasma levels of Malonyldialdehyde (MDA), Superoxide- dismutase (SOD), and Catalase were compared mean levels of healthy volunteers. Results: In patients of effort induced angina, after receiving allopurinol mean walking time (Pre-therapy 235.57±20.25; vs Post-therapy 368.3±22.65; p <0.001) and mean estimated maximum METs (5.71±0.21; vs 7.0±0.25; p <0.001) increased significantly, mean maximum ST depression (322.0±26.25; vs 229.0±19.33; p <0.05) significantly reduced, while no significant change was observed (97.56±16.9; vs 94.8±16.1; p >0.05) in mean of % THR in comparison to pre-therapy values. After allopurinol therapy MDA (Healthy volunteer 1.85±0.30; vs 3.8 ± 0.47; & 1.91 ± 0.41; p < 0.01) and catalase (Healthy volunteer 371.8±52.3; vs 387.35±36.5 ; & 246.53±27.51; p < 0.01) decreased while SOD (Healthy volunteer 25.8±2.85; vs 15.67±1.66; & 24.60 ± 1.52; p <0.001) increased significantly. Conclusion: Allopurinol has potential to ameliorate free radical induced myocardial injury and improve exercise tolerance in patient of exercise induced stable angina.

Keywords: Allopurinol; Stable angina; MDA; SOD; Catalase.