Impact of Allopurinol on early and one-year outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: A randomized controlled trial

Background: Due to the potential benefits of allopurinol in ischemic reperfusion injury, this randomized control trial was performed to evaluate the pretreatment allopurinol effect on major adverse cardiovascular events (MACE) in patients undergoing primary percutaneous coronary intervention (pPCI). Methods: A randomized controlled trial was performed on 170 firsttime STelevation myocardial infarction (STEMI) patients undergoing pPCI. Before the procedure, patients in intervention group (n=85) received 300 mg dose of allopurinol and control group (n=85) received placebo. Then, for the next 28 days, 100 mg of allopurinol was given to allopurinol group and placebo to the other group. Patients were compared regarding the baseline characteristics, clinical findings and oneyear MACE. Findings: Our findings showed that patients receiving allopurinol had significantly longer doortoballoon time than the control group (60.76±19.38 vs. 50.06±16.38, P value: 0.001). During one year of followup, heart failure (HF), cerebrovascular event (CVA) and mortality occurred more frequently in allopurinol group but differences were not statistically significant. No significant difference was also seen between the two groups regarding MACE during followup or hospitalization (P=0.179, 0.330 respectively). KaplanMeier curve could not show a significant difference between the two groups in terms of mortality and MACE (P=0.317 and 0.128 respectively). Conclusion: According to findings of this trial allopurinol had no cardioprotective effect against adverse cardiovascular events or death in patients undergoing pPCI. Trial Registration: Identifier: IRCT20140512017666N2; https://irct.behdasht.gov.ir/.