Allopurinol and angina

Q: Allopurinol also has an anti-anginal effect?

A) Yes

B) No

Answer: A

Allopurinol when compared with placebo, showed to increase the median time to ST depression as well as median total exercise time. The anti-ischemic effect of allopurinol is probably due to endothelium-dependent vasodilation and significant abolishing of oxidative stress. The effective dose is 600 mg per day.

Said that, at this point this effect is more of an academic interest. A large trial is needed before allopurinol can be prescribed for its anti-anginal effect.

#pharmacology

#cardiology

References:

1. Noman A, Ang DS, Ogston S, et al. Effect of high-dose allopurinol on exercise in patients with chronic stable angina: a randomised, placebo controlled crossover trial. Lancet 2010; 375:2161. 

2. Rajendra NS, Ireland S, George J, et al. Mechanistic insights into the therapeutic use of high-dose allopurinol in angina pectoris. J Am Coll Cardiol 2011; 58:820.