Myocardial ischemia and reperfusion result in ventricular dysfunction and arythmias. The aim of this study is to investigate the effectivity of allopurinol, an inhibitor of enzyme xantine oxydazse, in preventing reperfusion injury in coronary artery bypass patients.

Materials and Methods: Fifteen patients scheduled for elective coronary artery by-pass grafting (CABG) were included in this study, and the other 15 as a control group. A total of 1200 mg. allopurinol was given per orally to the study group patients, 600 mg. at the preoperative night, and 600 mg. in the morning just before to the operation. Cardiac index and left ventricular stroke work index (LVSWI) measurements were calculated for a period of 24 hours after cardio pulmonary by-pass (CPBP). Serum myocardial isoenzime of creatine kinase (CPK-MB), aspartat transferase (AST) and lactic dehidrogenase (LDH) level were studied just after the release of X-clamp and troughout 5 days once daily. The need for inotropic support and new begininng arrhythmias were noted in the clinical follow-up.

Results:

The study group had a better left ventricular performance, lesser arrythmias and lesser need for inotropic support than the control group. There was a reduced level of myocardial isoenzime of creatine kinase (CPK-MB), and lactic dehidrogenase (LDH) which were not significant. Levels of aspartat transferase (AST) were not different between two groups.

Conclusion:

Ischemia reperfusion injury of the myocardium can be reduced by preoperative use of allopurinol.