The APEX trial: Effects of allopurinol on exercise capacity, coronary and peripheral endothelial function, and natriuretic peptides in patients with cardiac syndrome X
| Autor: | Faisel Khan, Chim C. Lang, Awson Noman, Anna Maria Choy, Allan D. Struthers, Tiong K. Lim |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Time Factors Brachial Artery 030204 cardiovascular system & hematology Antioxidants 0302 clinical medicine Cardiac syndrome X Natriuretic Peptide Brain Medicine Pharmacology (medical) Brachial artery Endothelial dysfunction Microvascular Angina Cross-Over Studies Exercise Tolerance General Medicine Middle Aged Coronary Vessels Vasodilation Treatment Outcome Cardiology Female Cardiology and Cardiovascular Medicine Blood Flow Velocity medicine.drug Cardiac function curve medicine.medical_specialty Allopurinol Placebo 03 medical and health sciences Bruce protocol Double-Blind Method medicine.artery Internal medicine Coronary Circulation Humans Aged Pharmacology business.industry Coronary flow reserve Recovery of Function medicine.disease Surgery Oxidative Stress 030104 developmental biology Scotland Endothelium Vascular business Biomarkers |
| Zdroj: | Cardiovascular therapeutics. 36(1) |
| ISSN: | 1755-5922 |
| Popis: | The role of endothelial dysfunction and oxidative stress in the pathogenesis of cardiac syndrome X has recently been recognised. Allopurinol has previously been shown to improve endothelial dysfunction, reduce oxidative stress burden and improve myocardial efficiency. In this ‘proof of concept’ study, we investigated the effect of allopurinol on exercise capacity, coronary and peripheral endothelial function, and serum B-type natriuretic peptide (BNP: a marker of cardiac function and myocardial ischaemia) in patients with cardiac syndrome X. Methods and Results This study was a randomised, double-blind, placebo-control crossover trial. Nineteen patients (mean age 59±10 years, 11 women & 8 men) with cardiac syndrome X were randomised to a 6-week treatment with either allopurinol (600mg/day) or placebo. After 4 weeks of washout period, they were crossed over to the other arm. Outcomes measured at baseline and after treatment were maximum exercise time (ET) derived from Bruce protocol exercise treadmill test, serum BNP measurement, coronary flow reserve (CFR) as assessed by measuring response of flow velocity in the left anterior descending artery to adenosine and flow-mediated vasodilatation of the brachial artery (FMD). Allopurinol significantly reduced serum uric acid levels when compared with placebo (-48±24% vs 1·9±11%, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|