The Acute Effects of Allopurinol in Angina

  • Fiona Shearer

    Student thesis: Doctoral ThesisDoctor of Medicine


    Angina is pain or constricting discomfort that typically occurs at the front of the chest and may radiate to neck, shoulders, jaw or arms and is precipitated by physical exertion or emotional stress which increases myocardial demand. Allopurinol has been shown to prolong the time to ST depression on ETT, which is a marker of ischaemia. This may be via a number of mechanisms including effect on oxidative stress and endothelial stability.

    This three arm cross over, double blind study was designed to establish the time of onset of effect of allopurinol and the optimal dose. The primary outcome was time to ST depression. Secondary outcomes were total exercise time and effect on troponin, oxidised LDL, CRP and BNP levels.

    There were 26 participants with a mean age of 70.1 and 77% male. 5 participants did not complete the study. Due to challenges of recruitment this study was underpowered but it did appear at 24 hours post study drug administration there was an impact on both time to ST depression and total exercise time in the active arms of the trial. Furthermore it was shown total exercise time improved irrespective of whether the participant was in an active or placebo arm. This may suggest the protocol was contaminated by the training effect of repeated high intensity exercise.
    Date of Award2018
    Original languageEnglish
    SponsorsBritish Heart Foundation
    SupervisorAllan Struthers (Supervisor) & Chim Lang (Supervisor)

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