No evidence of coronary plaque stabilization by allopurinol in patients with acute coronary syndrome.

Yu, Miao; Gu, Jin; Shi, He-Shui; Zhu, Zheng-Feng; Yang, Fen; Yuan, Yuan-Fan; Shuai, Xin-Xin; Wei, Yu-Miao; Cheng, Min; Yuan, Jing; Xie, Tian; Yang, Yong; Li, Da-Zhu; Zhang, Min; Lu, Yong-Xin; Yang, Ming; Zhou, You-Cai; Cheng, Xiang

Yu, Miao; Gu, Jin; Shi, He-Shui; Zhu, Zheng-Feng; Yang, Fen; Yuan, Yuan-Fan; Shuai, Xin-Xin; Wei, Yu-Miao; Cheng, Min; Yuan, Jing; Xie, Tian; Yang, Yong; Li, Da-Zhu; Zhang, Min; Lu, Yong-Xin; Yang, Ming; Zhou, You-Cai; Cheng, Xiang.

Afiliação

Yu M; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Gu J; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Province Key Laboratory of Molecular Imaging, China.
Shi HS; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Province Key Laboratory of Molecular Imaging, China.
Zhu ZF; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Yang F; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Yuan YF; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Shuai XX; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Wei YM; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Cheng M; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Yuan J; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Xie T; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Yang Y; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Li DZ; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Zhang M; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Lu YX; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese
Yang M; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Province Key Laboratory of Molecular Imaging, China.
Zhou YC; Heilongjiang Aolida Ned Pharmaceutical Co.Ltd, China.
Cheng X; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China; Hubei Provincial Engineering Rese

J Cardiovasc Comput Tomogr ; 18(2): 195-202, 2024.

Article em En | MEDLINE | ID: mdl-38267335

ABSTRACT

ABSTRACT

BACKGROUND:

Allopurinol, a xanthine inhibitor that lowers uric acid concentration, has been proven to reduce inflammation and oxidative stress in patients with cardiovascular disease. However, it is unknown whether these beneficial effects translate into favorable plaque modiï¬cation in acute coronary syndromes (ACS). This study aimed to investigate whether allopurinol could improve coronary plaque stabilization using coronary computed tomography angiography (CCTA).

METHODS:

This was a prospective, single-center, randomized, double-blind clinical trial began in March 2019. A total of 162 ACS patients aged 18-80 years with a blood level of high-sensitivity C-reactive protein (hsCRP) â> â2 âmg/L were included. The subjects were randomly assigned in a 11 ratio to receive either allopurinol sustained-release capsules (at a dose of 0.25 âg once daily) or placebo for 12 months. The plaque analysis was performed at CCTA. The primary efficacy endpoint was the change in low-attenuation plaque volume (LAPV) from baseline to the 12-month follow-up.

RESULTS:

Among 162 patients, 54 in allopurinol group and 51 in placebo group completed the study. The median follow-up duration was 14 months in both groups. Compared with placebo, allopurinol therapy did not signiï¬cantly alter LAPV (-13.4 â± â3.7 â% vs. -17.8 â± â3.6 â%, p â= â0.390), intermediate attenuation plaque volume (-16.1 â± â3.0 â% vs. -16.2 â± â2.9 â%, p â= â0.992), dense calciï¬ed plaque volume (12.2 â± â13.7 â% vs. 9.7 â± â13.0 â%, p â= â0.894), total atheroma volume (-15.2 â± â3.2 â% vs. -16.4 â± â3.1 â%, p â= â0.785), remodeling index (2.0 â± â3.9 â% vs. 5.4 â± â3.8 â%, p â= â0.536) or hsCRP levels (-73.6 [-91.6-17.9] % vs. -81.2 [-95.4-47.7] %, p â= â0.286).

CONCLUSIONS:

Our ï¬ndings suggest that allopurinol does not improve atherosclerotic plaque stability or inï¬ammation in ACS.

Assuntos

Síndrome Coronariana Aguda; Alopurinol; Placa Aterosclerótica; Humanos; Síndrome Coronariana Aguda/diagnóstico por imagem; Síndrome Coronariana Aguda/tratamento farmacológico; Alopurinol/uso terapêutico; Proteína C-Reativa; Angiografia Coronária/métodos; Inflamação; Valor Preditivo dos Testes; Estudos Prospectivos; Adolescente; Adulto Jovem; Adulto; Pessoa de Meia-Idade; Idoso; Idoso de 80 Anos ou mais

Palavras-chave

Acute coronary syndromes; Allopurinol; Low attenuation plaque

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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Alopurinol / Síndrome Coronariana Aguda / Placa Aterosclerótica Tipo de estudo: Clinical_trials Limite: Adolescent / Adult / Aged / Aged80 / Humans / Middle aged Idioma: En Revista: J Cardiovasc Comput Tomogr Ano de publicação: 2024 Tipo de documento: Article

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