Department of Cardiology, Tehran University of Medical Science, Tehran.
School of Medicine, Hamadan University of Medical Sciences.
Coron Artery Dis. 2020 Sep;31(6):527-529. doi: 10.1097/MCA.0000000000000863.
No-reflow phenomenon as a serious complication following percutaneous coronary intervention, deteriorates clinical outcomes. Intracoronary (IC) Adenosine, seems to be a way to deal with it. One hundred four consecutive patients with ST-segment elevation myocardial infarction were randomized into two groups. Each group consisted of 52 patients who managed with two bolus doses of IC Adenosine (Adenosine group) or two bolus doses of IC normal saline (placebo group) administered before and after stenting. Thrombolysis in myocardial infarction (TIMI) grade flow, ST-segment resolution (STR) and post-procedural clinical outcomes were used as endpoints. IC adenosine led to lower rates of no-reflow based on TIMI grade flow scaling (15.4% vs. 44.3%; P-value: 0.02). STR classified as complete, partial and no resolution was similar between two groups (P-value: 0.748). Also, post-interventional clinical outcomes, including arrhythmia, left ventricular ejection fraction, hospitalization time, and 30 days mortality were similar between Adenosine and placebo groups.
无复流现象是经皮冠状动脉介入治疗后的一种严重并发症，可使临床预后恶化。冠状动脉内（IC）腺苷似乎是一种应对方法。104 例 ST 段抬高型心肌梗死患者被随机分为两组。每组各有 52 例患者，分别给予 IC 腺苷（腺苷组）或 IC 生理盐水（安慰剂组）两种推注剂量，在支架置入前后给予。心肌梗死溶栓（TIMI）分级血流、ST 段缓解（STR）和术后临床结局作为终点。根据 TIMI 分级血流评分，IC 腺苷可降低无复流发生率（15.4% vs. 44.3%；P 值：0.02）。两组 STR 完全缓解、部分缓解和无缓解的分类相似（P 值：0.748）。此外，腺苷组和安慰剂组的术后临床结局，包括心律失常、左心室射血分数、住院时间和 30 天死亡率也相似。
