Intracoronary adenosine decreases the incidence of no reflow during percutaneous intervention in patients with acute myocardial infarction

Abstract

Abstract: Aim To investig ate the role of intracoronary adenosine for the prevention of no reflow.Methods The procedural outcomes of 79 patient s who undertook percutaneous intervention in the setting of acute myocardial infarction was studied.Twenty-eight patients did not received int racoronary adenosine, and fiftyone received intracoronary adenosine bolluses (24-48 μg before and after each balloon inf lation).Results Eight patients who were not given adenosine experienced no reflow (28.6%) and high in-Hospital death rate, three of fif ty-one patients (5.9%) in the adenosine group experienced no reflow.No untoward complications were noted during adenosine infusion. Conclusion Int racoronary adenosine bolus administration during percutaneous intervention in the patients with acute my ocardial infarction is easy and safe and may significant lylessen the incidence of no reflow and may improve the outcome of this procedure.

Key words: acute myocardial infarction, adenosine, percutaneous transluminal coronary angioplasty, noreflow phenomenon

CLC Number:

CHEN Shao-Liang, YUAN Zen-Bai, YE Fei, FANG Wu-Wang, SONG Jie, TAN Huai-Qing, Tamari. Intracoronary adenosine decreases the incidence of no reflow during percutaneous intervention in patients with acute myocardial infarction[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2001, 6(4): 295-300.

References

1 Anderson JL, Karagounis L, Becker LC, et al.TIMI perfusion grade 3 but not grade 2 results in improved outcome after thromboly sis for my ocardial infarction:v entriculographic, enzymeatic, and electrocardiogr aphic evidence from the TEAM-3 study.Circulation, 1993;87:1829
2 Keiman NS, White HD, Ohman EM, et al.Mortality within 24 h of thrombolysis for myocardial infarction:the impo rtance of early reperfusion.Circulation, 1994;90: 2658
3 Simes RJ, Topol EJ, Holmes DR, et al.Link between the angiographic substudy and mo rtality outcomes in larg e randomized trial of myocar dial reperfusion:importance of early and complete infarct artery reperfusion.Circulation, 1995; 91:1923
4 Bates ER, Krell M L, Dean EN, et al.Demonstration of no reflow phenomenon by digital coronary arteriog raphy. Am J Cardiol, 1986;57:177
5 Jeremy RW, Links JM, Becker CC, et al.Prog ressive failure of coronary flow during reperfusion of myocardial infarction:documentation of the noreflow phenomeno n with positron emission tomog raphy.J Am Coll Cardiol, 1990; 16:695
6 Feld H, Lichstein E, Schachter J, et al.Early and late angiog raphic findings of the no reflow phenomnon following direct angioplasty as primary treatment for acute myocardial infarction.Am Heart J, 1992;123:782
7 Ito H, Tomooka T, Sakai N, et al.Lack of myocardial perfusion immediately after successful thromboly sis:a predictor of poor recovery of left ventricular function in anterior my ocardial infarction.Circula tion, 1992;85:1699
8 Ito H, Okamura A, Iwakura K, et al.Myocardial perfusion patterns related to thrombolysis in patients with AMI. Circulation, 1992;86:1778
9 Pitary s CJ.Reduction of reperfusion injury in a canine prepar ation by IC adenosine:impor tance of endothelium and no reflow phenomenon.Circulation, 1987;76:1135
10 Hanna GP, Ypih P, Fujise K, et al.Intracoronary adenosine administered during rotational atherectomy of complex lesions in native coronary arteries reduce the incidence of no reflow phenomenon.Cathet Cardio vasc Diag n, 1999;48: 275
11 Ishihara M, Sa to H, Tateishi H, et al.Attenuation of the no reflow phenomenon after coronary angioplasty for acute my ocardial infarction with intracoronary papaverine.Am Heart J, 1996;132:950
12 Rawitscher D, Levin TN, Co hen I, et al.Rapid reversal of no reflow using abciximan after coronary device intervention.Cathe t Cardiov asc Diag n, 1997;42:187
13 Furchgot RF.Role of endothelium in response of vascular smooth muscle.Circ Res, 1983;43:557
14 Smedly LA, Tonnesen MG, Sandhaus RA, et al.Neutro phil-mediated injury to endo thelial cells.J Clin I nvest, 1986;77:1233
15 Sacks T, Moldow CF, Craddok PR, et al.Oxy gen free radicals mediate endothelial damag e by complement-stimulate g ranulocy tes.J Clin Invest, 1978;61:1161
16 Cronstein BN, Kramer SB, Weissman G, et al.Adenosine: a physiolo gic modulator of superoxide anion generation by neutrophils.J Exp Med, 1983;158:1160
17 Cronstein BN, Levin RI, Belanoff J, et al.Adenosine:an endogenous inhibitor of neutrophil injury to endothelial cells.J Clin I nvest, 1986;78:760
18 Cronstein BN, Kramer SB, Ro sentein ED, et al.Adenosine modulates the generation of supero xide anion by stimulated human neutrophils via interaction with a specific cell receptor.Ann N Y Acad Sci, 1985;451:291
19 Reimer KA, Hill ML, Jennings RB, et al.Pro longed depletion of ATP and adenine nucleo tide pool due to delayed resynthesis of adenine nucleo tides following reversible myocardial injury in do gs.J Mol Cell Cardiol, 1981;13:229
20 My ers ML, Bolli R, Lekich RF, et al.Enhancement of recovery of my ocardial function by oxy gen-free radical scavengers after reversible regional ischemia.Circulation, 1985;72:915
21 Ely SW, Mentzer RM, Lasley RD, et al.Functional and me tabolic evidence of enhanced myocardial tolerance to ischemia and reperfusion with adenosine.Circulation, 1996; 93:1993
22 Ito H, Maruy ama A, Iwakura K, et al.Clinical implications of the no reflow phenomenon:a predictor of complications and left ventricular remodeling in reperfused anterio r wall myocardial infarction.Circulation, 1996;93:223
23 Piana RN, Paik GY, Moscci M, et al.Incidence and treatment o f no reflow after percutaneous coronary intervention.Circulation, 1994;89:2514
24 Marzilli M, Gliozheni E, Marraccini P, et al.Primary coronary angio plasty in acute my ocardial infarction:clinical correlates of the no reflow phenomenon.Int J Cardiol, 1998;65(suppl 1):S23
25 Morishima I, Sone T, Mokuno S, et al.Clinical significance of no reflow phenomenon observed on angiography after successful treatment of acute myocardial infarction with percutaneous transluminal coronary angioplasty.Am Heat J, 1995;130:239
26 Vallejo E, Pena MA, Norono O, et al.The no reflow phenomenon:its incidence and clinical characteristics in a series of cases.Arch I nst Cardiol Mex, 1998;68:247
27 Kloner RA, Ganote CE, Jenning s RB, et al.The no reflow phenomenon after temporary coronary occlusion in the dog.J Clin Invest, 1974;54:1496
28 Kloner RA.No reflow revisited.J Am Coll Cardiol, 1989; 14:1814
29 Abbo KM, Doo ris M, Glazier S.No reflow after percutaneous coronary intervention:clinical and ang iographic characteristics, treatment and outcome.Am J Cardiol, 1995; 75:549

[1]	HAO Xiao, ZHAO Mei, WANG Wenjing, ZHANG Feifei, LIU Huiliang, DANG Yi, LI Shuren, QI Xiaoyong. Application of sodium-glucose cotransporter 2 inhibitors in acute myocardial infarction [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(7): 824-831.
[2]	QIAN Jin, WANG Fengyan. Influence factors of serum NT-proBNP level in elderly patients with acute myocardial infarction after PCI and its influence on short-term prognosis [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(6): 658-665.
[3]	PAN Rongrong, ZHI Yinghao, JIN Yongxi, ZHOU Xiahui. Influences of theaflavins on neuronal apoptosis and blood-brain barrier in rats with cerebral hemorrhage by regulating CaMKK2/AMPK signaling pathway [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(11): 1240-1246.
[4]	ZHAO Wei, WU Youyang, LIN Cong, HUANG Shiwei, CHEN Hao, JIANG Wenbing. Effects of pterostilbene on myocardial function, myocardial fibrosis and inflammatory response in rats with acute myocardial infarction and on Notch1/eIF3a signaling pathway [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(5): 498-504.
[5]	XIA Honglian, ZHONG Weiwei, JIN Peng, CHEN Meng, LIU Zaiying, ZHANG Yanli. PI3K/AKT/GSK3β signaling pathway participates in the protective effect of adenosine A1R-mediated propofol on ischemia-reperfusion injury in rats [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(12): 1344-1350.
[6]	GUAN Qiaobing, HAN Chenyang, CHU Zhiyuan, YANG Yi, ZHANG Xiaoling. Mechanism of butylphthalide activating cAMP/CREB/BDNF signaling to improve cognitive impairment after ischemia-reperfusion in mice [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(2): 152-157.
[7]	CHEN Yu，YIN Weiyong，CHEN Yanyan，ZHU Zhenguo，ZHENG Rongyuan，ZHENG Liupu. Effects of adenosine A2A receptor antagonist on lipopolysaccharide induced inflammatory BV-2 microglial cells' morphology and function [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(12): 1376-1384.
[8]	PU Chun, TAO Qingsong, ZHU Xiang, QIN Mingming, WU Qiwen, FENG Gang. Value of three cardiac markers in the early diagnosis of acute myocardial infarction [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(1): 82-86.
[9]	LI Yi-min, HUANG Jin, LU Zhi-ping, LI Xiang-yu, HE Sheng-hu. Effects of tirofiban on the level of platelet microparticles(PMPs) in patients with acute ST-segment elevation myocardial infarction undergoing emergency interventional treatment [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(12): 1403-1406.
[10]	WANG Lin, LU Li. Effects of the adenosine 2A receptor-epoxyeicosatrienoic acids pathway in the treatment of salt-sensitive hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(12): 1436-1440.
[11]	LI Shu, ZHANG Gen-bao, HONG Yun, LU Xiao-hua. Study on mechanisms of Agkistrodon halyx pallas venom PCA to improve heart function in rats with acute myocardial infarction [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(2): 141-146.
[12]	YUE Xiao-fang, QIU Mei-hong, QU Wei-min, HUANG Zhi-li. Endogenous sleep-promoting substances [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(6): 672-678.
[13]	YU Jie, XU Qi, WANG Yi-qun. Progress in the roles of adenosine receptors in sleep-wake regulation [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(2): 214-218.
[14]	QIAO Hua, HE Sheng-hu, JI Jun, CHEN Shu, LIU Xiao-dong, XU Ri-xing, XIE Yong. Effects of recombinant human brain natriuretic peptide in Non-ST-segment elevation acute myocardial infarction patients with heart failure [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2010, 15(12): 1406-1409.
[15]	GAO Wen-jun, LIU Wen-jie, KE Yong-sheng. Clinical evidence-based study on new-generation drug-eluting stent: everolimus-eluting stents (Xience V) [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(5): 591-595.