APEX Study: Effects of Allopurinol on Coronary and Peripheral Endothelial Function in Patients With Cardiac Syndrome X
Status:
Completed
Trial end date:
2010-06-01
Target enrollment:
Participant gender:
Summary
Morbidity of patients with cardiac syndrome X (typical anginal-like chest pain and normal
coronary arteriograms) is high with continuing episodes of chest pain and frequent hospital
readmissions. Management of this syndrome represents a major challenge to the treating
physician. Evidence for the important role of endothelial dysfunction and oxidative stress in
the pathogenesis of cardiac syndrome X has been recently strengthened by the finding that
basal superoxide production predicts future cardiovascular events in this patient group. The
investigators have recently shown that high-dose allopurinol abolishes vascular oxidative
stress and improves endothelial function in patients with chronic heart failure, which makes
allopurinol a prime candidate to reduce oxidative stress in syndrome X. The hypothesis to be
tested in this study is whether allopurinol offers dual benefits of improving vascular
function and reducing myocardial ischaemia in patients with cardiac syndrome X. This study
may discover a novel way to improve endothelial function and anginal symptoms which are often
debilitating in these patients.