Myocardial protective effect of adenosine during percutaneous coronary intervention

Objective To evaluate the myocardial protective effects of intracoronary(IC)adenosine infusion in patients with coronary heart disease during percutaneous coronary intervention(PCI).Methods A total of 111 enrolled patients were randomised to receive infusions of saline(control group,55 patients)or adenosine(adenosine group,56 patients).10 mL saline(control group)or 300 μg adenosine(adenosine group)was given by intracoronary(IC)injection within 1 minute.The peak level of ST-segment elevation in IC electrocardiograms(IC-ECG)and the peak level of cardiac triponin I(cTnI)was analyzed and left ventricular ejection fraction(LVEF)was measured.For the patients with acute myocardial infarction(AMI),coronary flow of the infract-related artery was assessed by the method of thrombolysis in myocardial infarction grading.The peak level of sum ST-segment resolution(STR)was measured after one hour of PCI.Results The peak level of serum cTnI in adenosine group was lower than the control group(P0.05).In patients with AMI,sum STR in 1 hour after PCI of adenosine group was significantly higher than that in control group(P0.05).LVEF at the fourth week of PCI(both adenosine and control group)was better than those on the third day.LVEF in adenosine group was significantly higher than control group on the fourth week after PCI(P0.05).The incidence and level of ST-segment elevation in the patients with selective PCI were significantly higher in control group than adenosine group(P0.05).Conclusion IC adenosine infusion during PCI can decrease minute mycardial injury,significantly alleviating ischemia-reperfusion injury and improving the left ventricular function in AMI.