Table 2

Randomized Clinical Studies Investigating the Effects of Intracoronary Adenosine in Patients With AMI Undergoing Primary PCI

First Author (Year) (Ref. #)nEligibilityIschemia Time (min)Type of AdministrationDose of AdministrationAdministration Time (min)Start and Site of Adenosine AdministrationInfarct SizeReperfusion Markers
Marzilli et al. (2000) (24)54SO <3 h, pre-TIMI 0–2106Bolus4 mg in 2 ml1After wire crossing and balloon inflation distal to PCI site↓ peak CK/CK-MB (p = NS)↓ No-reflow (↓ ≥1 TIMI grades final angio relative to post-PCI angio)
Hendler et al. (2006) (17)20SO <12 h, post-TIMI 3 with MBG 0/1120Bolus60–120 μgNACatheter site↔ STR, TMPG
Stoel et al. (2008) (25)49STR <70% post-PCI196Infusion6 mg/ml5–10>10 min after last balloon inflation at catheter siteTrend ↓ peak CK-MB (p = 0.08)↑ STR >70%, MBG, ↓TFC
Fokkema et al. (2009) (11)448SO <12 h, pre-TIMI 0–3180Bolus (2×)2 × 120 μg in 20 mlNA1st bolus after TA, 2nd after stenting in IRA↔ peak CK/CK-MB↔ ST-deviation, STR, MBG, post-TIMI flow
Desmet et al. (2011) (10)110SO <12 h, pre-TIMI 0–3215Bolus4 mg in 5 ml1After wire crossing distal to target lesion site↔ AUC CK/CK-MB/TnI, MSI or IS MRI 4 months↔ STR, MBG, TFC, post-TIMI flow or MVO MRI 2–3 days
Grygier et al. (2011) (16)70SO <6 h, pre-TIMI 0–2273Bolus (2×)2 × (1 mg for RCA and 2 mg for LCA) in 10 mlNA1st bolus after wire crossing, 2nd after balloon inflation at occlusion site↔ peak CK/CK-MB/TnI↑ STR >50%, corrected TFC, MBG 3, post-TIMI 3 flow
Niccoli et al. (2013) (26)160SO <12 h, pre-TIMI 0/1277Bolus + (brief) infusion120 μg + 2 mg in 33 ml1st bolus fast + 2After wire crossing and TA beyond occlusion site↓ peak CK-MB/TnT↑ STR >70%, ↓ MVO (TFG ≤2 or MBG <2)
Garcia-Dorado et al. (2013) (46)201SO <6 h, persistent TIMI 0/1 after wire crossingNA(Brief) infusion4 mg2Immediately before reperfusion mostly with TA and direct stenting distal to culprit lesion↔ IS MRI 2–7 days or 6 months, ↓ IS in pts with SO <200 min (n = 84)↔ MVO MRI 2–7 days or 6 months

↓ = reduced; ↑ = improved; ↔ = unchanged; AMI = acute myocardial infarction; angio = angiogram; AUC = area under the curve; CK = creatine kinase; CK-MB = creatine kinase-myocardial band; IRA = infarct-related artery; IS = infarct size; LCA = left coronary artery; MBG = myocardial blush grade; MRI = magnetic resonance imaging; MSI = myocardial salvage index; MVO = microvascular obstruction; NA = not available; PCI = percutaneous coronary intervention; pts = patients; RCA = right coronary artery; SO = symptom onset; STR = ST-segment resolution; TA = thrombus aspiration; TFC = TIMI frame count; TFG = TIMI flow grade; TIMI = Thrombolysis In Myocardial Infarction; TMPG = TIMI myocardial perfusion grade; TnI = troponin I; TnT = troponin T.

  • Ischemia time in the adenosine groups.