Impact of Allopurinol Pretreatment on Coronary Blood Flow and RevascularizationOutcomes after Percutaneous Coronary Intervention in Acute STEMI Patients: ARandomized Double Blind Clinical Trial

Introduction: the generation of reactive oxygen species, which is induced by the activation of thexanthine oxidase (xo) enzymatic system, is one of the primary causes of ischemia-reperfusion injury foran ischemic heart. allopurinol, as an xo inhibitor, plays an inhibitory role in free radical production inst-elevation myocardial infarction (stemi) patients. the aim of this study is to evaluate the impact ofallopurinol pre-treatment on post-revascularization outcomes in patients admitted with stemimethod: ninety patients with acute stemi were enrolled in this randomized double-blind clinical trialand divided into two equal groups. the allopurinol group received a 600 mg allopurinol loading dose beforethe emergency pci, and the control group received a placebo medication of the same shape. thrombolysis inmyocardial infarction (timi) flow, ecg changes, troponin level, and the occurrence of major cardiac events(mace) during a 1-month follow-up were assessed.results: in the end, 81 patients were analyzed. the mean age of the patients was 59.52(11.31) and61.3(9.25) in the allopurinol and control groups, respectively (p = 0.49). the troponin level 48 hours afterthe pci and st-elevation regression showed no significant difference between the groups [(p = 0.25) and (p= 0.21), respectively]. timi flow had improved in the allopurinol group compared to the placebo (p = 0.02).the pci success rate was 78.6% and 61.5% in the case and control groups, respectively (p = 0.09). mace andother clinical outcomes were similar between the groups (p > 0.05).conclusion: this study revealed that allopurinol pre-treatment could improve timi flow in patientsundergoing primary or rescue pci in an acute stemi setting.