The following is a summary of “Allopurinol & Plaque Stabilization in Patients With Acute Coronary Syndrome: A Randomized Clinical Trial,” published in the November 2023 issue of cardiology by Yu et al.
Allopurinol lowers uric acid and reduces inflammation and oxidative stress in cardiovascular disease patients(pts). The effect of plaque modification in acute coronary syndromes (ACS) is unclear. Researchers aimed to evaluate whether allopurinol therapy could improve plaque stability in ACS pts using coronary computed tomography angiography (CCTA).
About 162 pts, aged 18-80, experiencing ACS with high-sensitivity C-reactive protein (hsCRP) levels > 2 mg/L were enrolled. Pts were assigned in a 1:1 ratio to receive either allopurinol sustained-release capsules (0.25 g once daily) or a placebo for 12 months. The primary efficacy endpoint measured the low-attenuation plaque volume (LAPV) change from baseline to the 12-month follow-up.
About 162 pts, 54 in the allopurinol group and 51 in the placebo group completed the study. No significant differences were seen between the two groups in baseline characteristics, including age (58.5±10.2 years vs. 56.8±10.0 years, P=0.392) and sex distribution (male/female, 40/14 vs. 40/11, P=0.600). The median follow-up duration was 14 months for both groups.
Allopurinol therapy, compared with placebo, did not significantly impact low-attenuation plaque volume (-13.4±3.7% vs. -17.8±3.6%, P=0.390), intermediate attenuation plaque volume (-16.1±3.0% vs. -16.2±2.9%, P=0.992), dense calcified plaque volume (12.2±13.7% vs. 9.7±13.0%, P=0.894), total atheroma volume (-15.2±3.2% vs. -16.4±3.1%, P=0.785), remodeling index (2.0±3.9% vs. 5.4±3.8%, P=0.536), or hsCRP levels (-73.6 [17.9-91.6] % vs. -81.2 [47.7-95.4] %, P=0.286).
The study found that allopurinol therapy does not improve plaque stability or inflammation in ACS pts.
Source: abstractsonline.com/pp8/#!/10871/presentation/8947
