Intracoronary adenosine as an adjunct to primary coronary intervention in acute myocardial infarction

Darahim, Khaled E.; Mahdy, Manal El; Ryan, Mona M.; Hassan, Ossama; Thabet, Sameh S; Abdelhamid, Mohammed Amin

doi:10.1016/j.jsha.2013.03.096

Cited by 2 publications

(1 citation statement)

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“…ST segment recovery has been shown to be related to cell membrane integrity, myocyte function and tissue level reperfusion (46). Many studies report the strong correlation between ST resolution and long-axis LV function (47,48).…”

Section: Comparison Between the 2 Cam Groupsmentioning

confidence: 99%

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Ammar

Al-Daydamony

Tahlawi

et al. 2015

Zagazig University Medical Journal

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Background: Accurate assessment of LV systolic function during primary PCI can help to optimize reperfusion strategies and has many prognostic implications. Circumflex artery motion (CAM) can be measured during primary PCI to reflect LV long-axis function which is an accurate indicator of LV systolic function. Aim of the work: to test the validity of CAM as a measurement of LV long-axis systolic function in anterior STEMI patients treated with primary PCI and to determine its prognostic value. Patients and Methods: CAM was measured using coronary angiography during primary PCI in 50 STEMI patients. Echocardioghraphic (M-mode, tissue Doppler and speckle-tracking) assessment of LV long-axis systolic function was performed within 24 hours after primary PCI. Follow-up echocardiography was scheduled after 6 months. Reverse remodeling was defined as a reduction >10% in LV end-systolic volume by the end of follow-up period. Results: Strong correlation was found between CAM and echocardiographic parameters of LV long-axis systolic function (p for each < 0.001) as well as LVEF (r= 0.845, p< 0.001) 24 hours after successful primary PCI. Patients were dichotomized according to the median value of CAM (median CAM: 13.9 mm). Supra-median CAM was associated with higher LVEF (56.0±7.4 vs. 42.6±3.6, p<0.001), lower peak troponin (6.43±2.6 vs. 11.13±2.78 ug/L, p<0.001) and lower incidence of composite major adverse cardiac events (3.8% vs. 45.8%, p=0.001). A CAM cutoff value of 10.8 mm (sensitivity 96% and specificity 100%) accurately predicted reverse remodeling at 6 months. Conclusion: CAM measured at the time of primary PCI can predict LV systolic function loss, adverse clinical outcome and reverse remodeling in STEMI patients. Thus it can gauge the choice of reperfusion strategy and adjunctive therapy.

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Section: Comparison Between the 2 Cam Groupsmentioning

confidence: 99%

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Ammar

Al-Daydamony

Tahlawi

et al. 2015

Zagazig University Medical Journal

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Adenosine as adjunctive therapy in acute coronary syndrome: a meta-analysis of randomized controlled trials

Laborante

Bianchini

Restivo

et al. 2022

European Heart Journal - Cardiovascular Pharmacotherapy

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Aim Adenosine has been tested in several randomized controlled trials (RCTs) to minimize the incidence of coronary microvascular obstruction (CMVO). The aim of the present study was to pool all the RCTs comparing intracoronary or intravenous adenosine versus placebo in patients with acute coronary syndrome (ACS) undergoing myocardial revascularization. Methods and results PubMed and Scopus electronic databases were scanned for eligible studies up to June 5th 2022. A total of 26 RCTs with 5843 patients were included. Efficacy endpoints were major adverse cardiac events (MACE), all-cause-death, non-fatal myocardial infarction and heart failure. Atrioventricular blocks and ventricular fibrillation/sustained ventricular tachycardia (VF/SVT) were the safety endpoints. Myocardial blush grade, Thrombolysis In Myocardial Infarction (TIMI) flow grade, left ventricular ejection fraction (LVEF), infarct size, and ST-segment resolution were also assessed. Adenosine administration was not associated with any clinical benefit in terms of MACE, all-cause death, non-fatal myocardial infarction, and heart failure. However, adenosine was associated with an increased rate of advanced atrioventricular blocks and of VF/SVT in studies with total mean ischemic time > 3 hours, compared to placebo. Remarkably, among patients undergoing percutaneous coronary intervention, adenosine was associated with reduced myocardial blush grade 0–1 and TIMI flow grade 0–2, compared to placebo. Furthermore, adenosine did not show favourable effects on LVEF and infarct size. Conclusion Adenosine infusion, as adjunctive therapy in ACS, was associated with an increased risk of advanced atrioventricular blocks and increased rates of adenosine-triggered ventricular arrhythmias in patients with long ischemic time, without providing any clinical benefit compared to placebo.

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Intracoronary adenosine as an adjunct to primary coronary intervention in acute myocardial infarction

Cited by 2 publications

References 0 publications

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Prognostic Value of Circumflex Artery Motion as a Measurement of Left Ventricular Long-Axis Systolic Function in Patients Treated With Percutaneous Coronary Intervention

Adenosine as adjunctive therapy in acute coronary syndrome: a meta-analysis of randomized controlled trials

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