De Marco Corrado, Charron Thierry, Rousseau Guy
CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur, Department of Medicine, QC, Montréal, Canada.
Department of Medicine, Université de Montréal, Montréal, QC, Canada.
Front Pharmacol. 2022 May 13;13:856747. doi: 10.3389/fphar.2022.856747. eCollection 2022.
The mainstay of acute myocardial infarction has long been timely reperfusion of the culprit obstruction. Reperfusion injury resulting from a multitude of pathophysiological processes has been demonstrated to negatively affect myocardial recovery and function post-infarction. Adenosine interacts directly with the sequential pathophysiological processes culminating in reperfusion injury by inhibiting them upstream. The evidence for adenosine's benefit in acute myocardial infarction has produced mixed results with regards to myocardial salvage and long-term mortality. The heterogenous evidence with regards to benefits on clinical outcomes has resulted in modest uptake of adenosine in the clinical setting. However, it is critical to analyze the variability in study methodologies. The goal of this review is to evaluate how adenosine dose, route of administration, timing of administration, and site of administration play essential roles in the molecule's efficacy. The benefits of adenosine, as highlighted in the following review, are clear and its role in the treatment of acute myocardial infarction should not be discounted.
长期以来，急性心肌梗死的主要治疗方法一直是及时开通导致梗死的罪犯血管阻塞。多种病理生理过程导致的再灌注损伤已被证明会对梗死后的心肌恢复和功能产生负面影响。腺苷通过在上游抑制这些过程，直接与导致再灌注损伤的一系列病理生理过程相互作用。关于腺苷在急性心肌梗死中的益处，在心肌挽救和长期死亡率方面产生了不一致的结果。关于临床结局益处的异质性证据导致腺苷在临床环境中的应用较少。然而，分析研究方法的变异性至关重要。本综述的目的是评估腺苷的剂量、给药途径、给药时间和给药部位如何在该分子的疗效中发挥重要作用。如下文综述所强调的，腺苷的益处是明确的，其在急性心肌梗死治疗中的作用不应被忽视。
