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El alopurinol mejora la disfunción endotelial en la insuficiencia cardíaca crónica.
Colin A J Farquharson1, Robert Butler, Alexander Hill
1Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK.
Circulation
|July 10, 2002
Resumen
El alopurinol mejoró significativamente la disfunción endotelial en pacientes con insuficiencia cardíaca crónica al reducir el estrés oxidativo. Esto sugiere beneficios potenciales para los eventos cardiovasculares y la capacidad de ejercicio.
Área de la Ciencia:
- Cardiología Cardiología.
- Farmacología Farmacología.
- El estrés oxidativo Investigación de la investigación
Sus antecedentes:
- El estrés oxidativo está implicado en la disfunción endotelial en la insuficiencia cardíaca crónica.
- La xantina oxidasa es una enzima clave que produce estrés oxidativo.
Objetivo del estudio:
- Para investigar el efecto del allopurinol en la disfunción endotelial en la insuficiencia cardíaca crónica.
- Para determinar si el alopurinol reduce los marcadores de estrés oxidativo en estos pacientes.
Principales métodos:
- Un estudio cruzado aleatorizado, controlado con placebo y doble ciego en el que participaron 11 pacientes con insuficiencia cardíaca crónica (clase II-III de la Asociación del Corazón de Nueva York).
- Los pacientes recibieron 300 mg de alopurinol al día o placebo durante un mes.
- La función endotelial se evaluó mediante plethysmografía de oclusión venosa del antebrazo con acetilcolina, nitroprussida y verapamil.
- Los niveles plasmáticos de malondialdehído se midieron como un marcador del estrés oxidativo.
Principales resultados:
- El alopurinol mejoró significativamente la respuesta del flujo sanguíneo del antebrazo a la acetilcolina en comparación con el placebo (181+/-19% frente a 120+/-22%, P=0,003).
- No se observaron diferencias significativas en las respuestas a la nitroprussida o verapamil entre los grupos de tratamiento.
- El tratamiento con alopurinol condujo a una reducción significativa de los niveles plasmáticos de malondialdehído (346+/-128 nmol/L frente a 461+/-101 nmol/L, P=0,03), lo que indica una reducción del estrés oxidativo.
Conclusiones:
- El alopurinol mejora eficazmente la disfunción endotelial en pacientes con insuficiencia cardíaca crónica.
- Estos hallazgos sugieren que el allopurinol puede ofrecer un beneficio terapéutico en la reducción de eventos cardiovasculares y la mejora de la capacidad de ejercicio en esta población de pacientes.
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