High dose adenosine for suboptimal myocardial reperfusion after primary PCI: A ramdomized placebo-controlled pilot study

Martin G. Stoel; Koen M.J. Marques; Carel C. de Cock; Jean G.F. Bronzwaer; Clemens von Birgelen; Felix Zijlstra

doi:10.1002/ccd.21334

High dose adenosine for suboptimal myocardial reperfusion after primary PCI: A ramdomized placebo-controlled pilot study

Martin G. Stoel (Corresponding Author), Koen M.J. Marques, Carel C. de Cock, Jean G.F. Bronzwaer, Clemens von Birgelen, Felix Zijlstra

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVES: This study was designed to investigate the influence of high dose intracoronary adenosine on persistent ST-segment elevation after primary percutaneous coronary intervention (PCI).

BACKGROUND: After successful PCI for acute myocardial infarction 40-50% of patients show persistent ST-segment elevation indicating suboptimal myocardial reperfusion. Adenosine has been studied to ameliorate reperfusion and is frequently used in a variety of doses, but there are no prospective studies to support its use for treatment of suboptimal reperfusion.

METHODS: We conducted a blinded, randomized, and placebo-controlled study with high dose intracoronary adenosine in 51 patients with <70% ST-segment resolution (STRes) after successful primary PCI. All patients were treated with stents and abciximab.RESULTS: Immediately after adenosine, significantly more patients showed optimal (>70%) STRes compared with placebo (33% versus 9%, P < 0.05). Mean STRes was higher after adenosine (35.4% versus 23.0%, P < 0.05). In addition, TIMI frame count was significant lower (15.7 versus 30.2, P < 0.005), Myocardial Blush Grade was higher (2.7 versus 2.0, P < 0.05) and resistance index was lower in the adenosine group (0.70 versus 1.31 mm Hg per ml/min, P < 0.005).

CONCLUSIONS: Intracoronary adenosine accelerates recovery of microvascular perfusion in case of persistent ST segment elevation after primary PCI.

Original language	English
Pages (from-to)	283-289
Number of pages	7
Journal	Catheterization and cardiovascular interventions
Volume	71
Issue number	3
DOIs	https://doi.org/10.1002/ccd.21334
Publication status	Published - 2008

Keywords

METIS-254337
Adenosine
Myocardial infarction
Primary percutaneous coronary intervention
ST-segment resolution
Reperfusion

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/ccd.21334

Cite this

@article{e0bc709c68704c5eae70eb453ffb6698,

title = "High dose adenosine for suboptimal myocardial reperfusion after primary PCI: A ramdomized placebo-controlled pilot study",

abstract = "OBJECTIVES: This study was designed to investigate the influence of high dose intracoronary adenosine on persistent ST-segment elevation after primary percutaneous coronary intervention (PCI).BACKGROUND: After successful PCI for acute myocardial infarction 40-50% of patients show persistent ST-segment elevation indicating suboptimal myocardial reperfusion. Adenosine has been studied to ameliorate reperfusion and is frequently used in a variety of doses, but there are no prospective studies to support its use for treatment of suboptimal reperfusion.METHODS: We conducted a blinded, randomized, and placebo-controlled study with high dose intracoronary adenosine in 51 patients with <70% ST-segment resolution (STRes) after successful primary PCI. All patients were treated with stents and abciximab.RESULTS: Immediately after adenosine, significantly more patients showed optimal (>70%) STRes compared with placebo (33% versus 9%, P < 0.05). Mean STRes was higher after adenosine (35.4% versus 23.0%, P < 0.05). In addition, TIMI frame count was significant lower (15.7 versus 30.2, P < 0.005), Myocardial Blush Grade was higher (2.7 versus 2.0, P < 0.05) and resistance index was lower in the adenosine group (0.70 versus 1.31 mm Hg per ml/min, P < 0.005).CONCLUSIONS: Intracoronary adenosine accelerates recovery of microvascular perfusion in case of persistent ST segment elevation after primary PCI.",

keywords = "METIS-254337, Adenosine, Myocardial infarction, Primary percutaneous coronary intervention, ST-segment resolution, Reperfusion",

author = "Stoel, {Martin G.} and Marques, {Koen M.J.} and {de Cock}, {Carel C.} and Bronzwaer, {Jean G.F.} and {von Birgelen}, Clemens and Felix Zijlstra",

year = "2008",

doi = "10.1002/ccd.21334",

language = "English",

volume = "71",

pages = "283--289",

journal = "Catheterization and cardiovascular interventions",

issn = "1522-1946",

publisher = "Wiley",

number = "3",

}

High dose adenosine for suboptimal myocardial reperfusion after primary PCI: A ramdomized placebo-controlled pilot study. / Stoel, Martin G. (Corresponding Author); Marques, Koen M.J.; de Cock, Carel C. et al.
In: Catheterization and cardiovascular interventions, Vol. 71, No. 3, 2008, p. 283-289.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - High dose adenosine for suboptimal myocardial reperfusion after primary PCI

T2 - A ramdomized placebo-controlled pilot study

AU - Stoel, Martin G.

AU - Marques, Koen M.J.

AU - de Cock, Carel C.

AU - Bronzwaer, Jean G.F.

AU - von Birgelen, Clemens

AU - Zijlstra, Felix

PY - 2008

Y1 - 2008

N2 - OBJECTIVES: This study was designed to investigate the influence of high dose intracoronary adenosine on persistent ST-segment elevation after primary percutaneous coronary intervention (PCI).BACKGROUND: After successful PCI for acute myocardial infarction 40-50% of patients show persistent ST-segment elevation indicating suboptimal myocardial reperfusion. Adenosine has been studied to ameliorate reperfusion and is frequently used in a variety of doses, but there are no prospective studies to support its use for treatment of suboptimal reperfusion.METHODS: We conducted a blinded, randomized, and placebo-controlled study with high dose intracoronary adenosine in 51 patients with <70% ST-segment resolution (STRes) after successful primary PCI. All patients were treated with stents and abciximab.RESULTS: Immediately after adenosine, significantly more patients showed optimal (>70%) STRes compared with placebo (33% versus 9%, P < 0.05). Mean STRes was higher after adenosine (35.4% versus 23.0%, P < 0.05). In addition, TIMI frame count was significant lower (15.7 versus 30.2, P < 0.005), Myocardial Blush Grade was higher (2.7 versus 2.0, P < 0.05) and resistance index was lower in the adenosine group (0.70 versus 1.31 mm Hg per ml/min, P < 0.005).CONCLUSIONS: Intracoronary adenosine accelerates recovery of microvascular perfusion in case of persistent ST segment elevation after primary PCI.

AB - OBJECTIVES: This study was designed to investigate the influence of high dose intracoronary adenosine on persistent ST-segment elevation after primary percutaneous coronary intervention (PCI).BACKGROUND: After successful PCI for acute myocardial infarction 40-50% of patients show persistent ST-segment elevation indicating suboptimal myocardial reperfusion. Adenosine has been studied to ameliorate reperfusion and is frequently used in a variety of doses, but there are no prospective studies to support its use for treatment of suboptimal reperfusion.METHODS: We conducted a blinded, randomized, and placebo-controlled study with high dose intracoronary adenosine in 51 patients with <70% ST-segment resolution (STRes) after successful primary PCI. All patients were treated with stents and abciximab.RESULTS: Immediately after adenosine, significantly more patients showed optimal (>70%) STRes compared with placebo (33% versus 9%, P < 0.05). Mean STRes was higher after adenosine (35.4% versus 23.0%, P < 0.05). In addition, TIMI frame count was significant lower (15.7 versus 30.2, P < 0.005), Myocardial Blush Grade was higher (2.7 versus 2.0, P < 0.05) and resistance index was lower in the adenosine group (0.70 versus 1.31 mm Hg per ml/min, P < 0.005).CONCLUSIONS: Intracoronary adenosine accelerates recovery of microvascular perfusion in case of persistent ST segment elevation after primary PCI.

KW - METIS-254337

KW - Adenosine

KW - Myocardial infarction

KW - Primary percutaneous coronary intervention

KW - ST-segment resolution

KW - Reperfusion

U2 - 10.1002/ccd.21334

DO - 10.1002/ccd.21334

M3 - Article

SN - 1522-1946

VL - 71

SP - 283

EP - 289

JO - Catheterization and cardiovascular interventions

JF - Catheterization and cardiovascular interventions

IS - 3

ER -

High dose adenosine for suboptimal myocardial reperfusion after primary PCI: A ramdomized placebo-controlled pilot study

Abstract

Keywords

UN SDGs

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