Effectiveness of Allopurinol and Quercetin inclusion in a complex treatment of stable angina pectoris – peculiarities of biomarkers and homeostatic indices changes

Authors

  • V.K. Tashchuk Higher Educational Establishment of Ukraine "Bukovina State Medical University", Chernivtsi,
  • Muhamed Vasek Obeid Al Salama Higher Educational Establishment of Ukraine "Bukovina State Medical University", Chernivtsi,
  • T. М. Amelina Higher Educational Establishment of Ukraine "Bukovina State Medical University", Chernivtsi,

DOI:

https://doi.org/10.14739/2310-1210.2017.3.100587

Keywords:

Allopurinol, quercetin, uric acid, C-reactive protein, NT-proBNP

Abstract

Objective – to study the effectiveness of Allopurinol and Quercetin inclusion in a complex treatment of stable angina pectoris and peculiarities of biomarkers and homeostatic indices changes.

Materials and Methods. 120 patients with the diagnosis of stable angina pectoris (SAP) and hyperuricemia (HU) were examined and three groups were formed: patients receiving a complex standard therapy (70 persons – 58,33%), patients receiving the standard therapy with addition of Allopurinol (23 persons – 19,17%), and patients receiving Quercetin in addition to the standard therapy (27 individuals – 22,50%). At the beginning of in-patient treatment and 6 months later during out-patient period all patients were clinically and laboratory examined (uric acid, total cholesterol (TC), triglycerides (TG), creatinine, NT-proBNP, С-reactive protein (СRP) and total testosterone (TT) in the blood serum).

Results. Reduced content of TC and TG in the 1st, 2nd and 3rd groups of a complex treatment was found (р<0,05; р<0,001 and р<0,001 respectively) with prevailing effect of Allopurinol compared with the standard treatment. In case of standard treatment elevated initial plasma levels of uric acid and creatinine were found (р<0,001 in both cases) that can probable be explained by the loop diuretics administration to achieve euvolemic condition. The indicated effect of diuretics is compensated by Allopurinol and Quercetin inclusion in the therapy (р<0,001 by all indices) with prevailing effect of Allopurinol compared with the standard (р<0,05). In comparison with the standard therapy addition of both Allopurinol and Quercetin promotes reduction of NT-proBNP initial content (in both cases р<0,05). A positive dynamics concerning inflammatory activity with reduction of the initial concentration of CRP (р<0,001) is achieved only with addition of Allopurinol to the therapy.

Conclusions. Addition of Allopurinol into the standard therapy of patients with SAP and asymptomatic HU promotes the dynamics of inflammatory activity with reduction of CRP initial concentration. Addition of Allopurinol or Quercetin to the standard therapy normalizes dyslipidemia by means of TC and TG content decreasing, improves renal function and reduces creatinine level with prevailing effect of Allopurinol, promotes reduction of NT-proBNP initial content. Inflammatory activity and dyslipidemia with elevated levels of TC and TG are the criteria for additional Allopurinol administration for the patients with SAP and asymptomatic HU.

 

References

Gandzyuk, V. A. (2014). Analiz zakhvoriuvanosti na ishemichnu khvorobu sertsia v Ukraini [Analysis of ischemic heart disease morbidity in Ukraine]. Ukrainskyi kardiolohichnyi zhurnal, 3, 45–52. [in Ukrainian].

Wong, C. K., Chen, Y., Ho, L. M., Zhen, Z., Siu, C. W., Tse, H. F., & Yiu, K. H. (2014). The effects of hyper uricaemia on flow-mediated and nitroglycerin-mediated dilatation in high-risk patients. Nutrition, metabolism, and cardiovascular diseases, 24(9), 1009–1012. doi: 10.1016/j.numecd.2014.02.006.

Stamp, L., & Dalbeth, N. (2017). Urate-lowering therapy for asymptomatic hyper uricaemia: A need for caution. Seminars in Arthritis and Rheumatism, 46(4), 457–464. doi: 10.1016/j.semarthrit.2016.07.015.

Kovalenkо, V. M., Lutai, M. I., & Sirenkо, Yu. M. (Eds.) (2011) Sertsevo-sudynni zakhvoriuvannia. Klasyfikatsiia, standarty diahnostyky ta likuvannia [Cardio-vascular diseases. Classification, standards of diagnostics and treatment]. Kyiv. [in Ukrainian].

Zaremba, Ye. Kh., Zaremba, O. V., Zaremba-Fedyshyn, O. V., Virna, M. M., & Shevchun-Pudlyk, O. M. (2014). Dynamika pokaznykiv lipidnoho spektra krovi u patsiientiv z ishemichnoiu khvoroboiu sertsia pislia vykorystannia kvertsetynu [Dynamics of lipid profile in patients with coronary heart disease after using quercetin]. Ukrainskyi kardiolohichnyi zhurnal, 4, 77. [in Ukrainian].

Ziga, N., & Becic, F. (2013). Allopurinol effect on values of lipid profile fractions in hyperuricemic patients diagnosed with metabolic syndrome. Materia socio-medica, 25(3), 167–169. doi: 10.5455/msm.2013.25.167169.

Qu, L. H., Jiang, H., & Chen, J. H. (2017). Effect of uric acid-lowering therapy on blood pressure: systematic review and meta-analysis. Annals of medicine, 49(2), 142–156. doi: 10.1080/07853890.2016.1243803.

Li, P., Luo, Y., & Chen, Y. M. (2013). B-type natriuretic peptide-guided chronic heart failure therapy: a meta-analysis of 11 randomised controlled trials. Heart, lung & circulation, 22(10), 852–860. doi.10.1016/j.hlc.2013.03.077.

Liu, P., Wang, H., Zhang, F., Chen, Y., Wang, D., & Wang, Y. (2015). The Effects of Allopurinol on the Carotid Intima-media Thickness in Patients with Type 2 Diabetes and Asymptomatic Hyperuricemia: A Three-year Randomized Parallel-controlled Study. Internal medicine, 54(17), 2129–2137. doi: 10.2169/internalmedicine.54.4310.

How to Cite

1.
Tashchuk V, Obeid Al Salama MV, Amelina TМ. Effectiveness of Allopurinol and Quercetin inclusion in a complex treatment of stable angina pectoris – peculiarities of biomarkers and homeostatic indices changes. Zaporozhye Medical Journal [Internet]. 2017May5 [cited 2024Dec.25];(3). Available from: http://zmj.zsmu.edu.ua/article/view/100587

Issue

Section

Original research