title: Evaluation of Short- and Long-Term Efficacy of Combined Intracoronary Administration of High-Dose Adenosine and Tirofiban during Primary Percutaneous Coronary Intervention.
abstract: BACKGROUND
  To assess the influence of combined intracoronary application of high-dose adenosine and tirofiban in primary percutaneous coronary intervention (PCI) on clinical events and cardiac function.
  
  
  METHODS
  Our study evaluated consecutive patients with acute ST-segment elevation myocardial infarction undergoing primary PCI, who were randomly divided into adenosine group (n = 130) and control group (n = 128). Combined with thrombus aspiration and then intracoronary tirofiban, the adenosine group received intracoronary adenosine (2 mg) through the aspiration catheter 2 times. After thrombus aspiration and stenting of the infarct- related artery, the control group received placebo. The primary endpoint of our investigation was major adverse cardiac events (MACE) at the 1-year and 3-year marks. The secondary endpoint comprised left ventricular remodeling (LVR) at 6 months, myocardial blush grade (MBG), thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count (CTFC) after PCI.
  
  
  RESULTS
  Our study found that TIMI flow grade post-PCI did not differ significantly between the 2 groups, while CTFC favored the adenosine-treated patients (21.6 ± 6.5 vs. 25.1 ± 7.8, p = 0.001). Although the adenosine group achieved a higher rate of MBG 3 (45.1% vs. 32.0%, p = 0.035) and MBG 2-3 (76.2% vs. 62.3%, p = 0.018) than the control group, the incidences of MACE at 1 year (20.0% vs. 25.0%, p = 0.373) and 3 years (26.9% vs. 32.0%, p = 0.413) were comparable. LVR occurred in 23.1% (27/117) of adenosine-treated patients and in 29.8% (43/114) of the controls (p = 0.296).
  
  
  CONCLUSIONS
  Intracoronary administration of high-dose adenosine combined with intracoronary tirofiban and thrombus aspiration may further improve myocardial perfusion after primary PCI.
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Li
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Feiou
authors.initials: F
authors.lastname: Li
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zong
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Guobin
authors.initials: G
authors.lastname: Miao
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Xinchun
authors.initials: X
authors.lastname: Yang
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Zichuan
authors.initials: Z
authors.lastname: Tong
authors.affiliation: Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhang
keywords: Adenosine; Angioplasty; Myocardial infarction; Remodeling