title: Effect of new method of intracoronary adenosine injection during primary percutaneous coronary intervention on microvascular reperfusion injury - clinical outcome and 1-year follow-up.
abstract: OBJECTIVE
  The aim of this single-center, randomized placebo-controlled trial in 70 consecutive patients (64 ± 14 years) with acute myocardial infarction was to examine the role of a new protocol of adenosine administration during primary angioplasty on immediate electrocardiographic and angiographic results, clinical outcome and 1-year follow-up.
  
  
  METHODS
  Group A (n = 35) twice received intracoronary adenosine through the guiding catheter: immediately after crossing the lesion of the infarct-related artery with guidewire and then after first balloon inflation. Group B (n = 35) received placebo.
  
  
  RESULTS
  Resolution of ST segment elevation was more frequently observed in the adenosine than in the placebo group (p < 0.01). Percutaneous coronary intervention (PCI) resulted in borderline better TIMI 3 flow after the procedure in the adenosine group than in the placebo group. Myocardial blush grade 3 at the end of the procedure was significantly improved in the adenosine compared to the placebo group (p < 0.05). At 1-year the composite end-point of death, recurrent myocardial infarction, heart failure and clinically driven target vessel revascularization was present in 8 patients in the adenosine group and 16 patients in placebo group (p < 0.05).
  
  
  CONCLUSIONS
  Intracoronary adenosine improved electrocardiographic and angiographic results in patients undergoing primary PCI and seemed to be associated with more favorable clinical course.
authors.affiliation: Chair and 1st Department of Cardiology, Poznan University of Medical Sciences, PL–61-848 Poznań, Poland. mgrygier @ wp.pl
authors.forename: Marek
authors.initials: M
authors.lastname: Grygier
authors.forename: Aleksander
authors.initials: A
authors.lastname: Araszkiewicz
authors.forename: Maciej
authors.initials: M
authors.lastname: Lesiak
authors.forename: Stefan
authors.initials: S
authors.lastname: Grajek
mesh_terms: D000241:Adenosine / Q000008:administration & dosage*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D055806:Microvessels / Q000502:physiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention; D055502:Secondary Prevention; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine