NEW YORK (Reuters Health) – For patients with ST-segment elevated MI undergoing primary percutaneous coronary intervention (PCI), a simple protocol of intracoronary administration of adenosine during the procedure improves immediate results, a Polish team reports.

The findings appear in the American Journal of Cardiology online February 11. Dr. Marek Grygier and colleagues at Poznan University of Medical Sciences note that various vasodilators have been tried to reduce the no-reflow phenomenon after PCI. Adenosine dilates coronary vessels and counters mechanisms involved in ischemia-reperfusion injury.

The researches conducted a trial of intracoronary adenosine in 70 consecutive STEMI patients undergoing PCI. Half the group received adenosine through the guiding catheter immediately after the guidewire crossed the coronary lesion and again after the first balloon inflation. The other half of the study group received saline placebo at the same points.

“Myocardial blush grade 3 was observed in 23 patients (65.7%) in adenosine group and 13 patients (37.1%) in placebo group (p50%) was more frequently observed in the adenosine than in the placebo group: 27 (77%) versus 15 (43%) patients, respectively (p<0.01).” TIMI grade 3 flow was achieved in 32 patients (91.4%) in the adenosine group and 27 patients (77.1%) in the placebo group (p= 0.059), according to the report. Intracoronary injections of adenosine or saline were well tolerated, and no deaths or recurrent MIs occurred, Dr. Grygier and colleagues note. They conclude, “Adenosine administration seemed to be associated with a more favorable clinical course.” Reference:
New Method of Intracoronary Adenosine Injection to Prevent Microvascular Reperfusion Injury in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Am J Cardiol 2011.