Effects of Allopurinol in the Prevention of Periprocedural Myocardial Injury Following Elective Percutaneous Coronary Intervention: A Randomized Clinical Trial

Background: Periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) is a substantial health issue with a high mortality rate. Inflammation and oxidative stress are major contributing factors to PMI. Allopurinol inhibits xanthine oxidase (XO)-induced oxidative stress and has potential cardiovascular benefits. Methods: This randomized clinical trial evaluated 110 patients admitted to elective PCI. Patients were assigned to receive either a 1200 mg loading dose of allopurinol 2 hours before the procedure (n = 55) or the standard pretreatment (n = 55). The creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) levels were measured in both groups at the baseline, 8, and 24 hours after PCI. Results: There were no significant differences in the CK-MB levels at baseline (P = 0.71), 8 (P = 0.26), and 24 hours (P = 0.88) after PCI between the two groups. No significant changes in the cTnI levels at baseline (P = 0.26), 8 (P = 0.80), and 24 hours (P = 0.89) after the PCI were also noted. The mean difference for CK-MB and cTnI changes was not different between the two groups. Conclusion: Our study revealed that allopurinol did not reduce cardiac-specific enzymes. Further studies are required to evaluate the impact of allopurinol on preventing PCI-related myocardial injury.