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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Adenosine as an Adjunctive Therapy for Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary
Xue-Mei Feng1, Wen-Hui Zhang2, Jia Liu3
1School of Basic Medical Sciences, Shanghai Jiaotong University, 200025 Shanghai, China.
Insights
Adenosine administration significantly improves ST resolution and reduces major adverse cardiovascular events (MACEs) in patients undergoing percutaneous coronary intervention (PCI). This meta-analysis confirms adenosine
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Adenosine may improve coronary blood flow during primary percutaneous coronary intervention (PCI).
- The impact of adenosine on ST resolution and major adverse cardiovascular events (MACEs) post-PCI requires clarification.
- Acute myocardial infarction (AMI) patients undergoing PCI are the focus for evaluating adenosine's therapeutic potential.
Purpose of the Study:
- To evaluate the therapeutic effects of adjunctive adenosine administration in patients with AMI undergoing PCI.
- To assess adenosine's impact on ST resolution and MACEs through a meta-analytic approach.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane Library up to March 2024.
- Inclusion of randomized controlled trials (RCTs) focusing on ST resolution and MACEs as primary outcomes.
- Random-effects model meta-analysis with sensitivity and subgroup analyses.
Main Results:
- Twenty-one RCTs with 2467 AMI patients were analyzed.
- Adenosine significantly increased ST resolution (RR: 1.30) and reduced MACEs (RR: 0.67).
- Adenosine use was linked to decreased no-reflow, improved myocardial blush grade, reduced heart failure risk, and lower peak CK-MB levels.
Conclusions:
- Adenosine administration is associated with enhanced ST resolution.
- Adjunctive adenosine therapy in PCI for AMI patients reduces the risk of MACEs.
Background:
Adenosine administration can improve coronary blood flow in patients undergoing primary percutaneous coronary intervention (PCI); however, the therapeutic effects of adenosine on ST resolution and major adverse cardiovascular events (MACEs) after PCI remain unclear. This study aimed to assess the therapeutic effects of adjunctive adenosine administration on patients with acute myocardial infarction (AMI) undergoing PCI using a meta-analytic approach.
Methods:
We conducted a systematic search across PubMed, Embase, and the Cochrane Library to identify eligible randomized controlled trials (RCTs) published from inception through to March 2024. Primary outcomes included ST resolution and MACEs. The pooled analyses were all conducted using the random-effects model. Additionally, exploratory analyses were carried out through the application of sensitivity and subgroup analyses.
Results:
Twenty-one RCTs involving 2467 patients with AMI were selected for the meta-analysis. Adenosine significantly increased the incidence of ST resolution (relative risk [RR]: 1.30; 95% confidence interval [CI]: 1.15-1.46; p < 0.001), while it significantly reduced the risk of MACEs (RR: 0.67; 95% CI: 0.51-0.87; p = 0.003). Moreover, the use of adenosine was associated with reduced incidences of no reflow (RR: 0.35; 95% CI: 0.24-0.52; p < 0.001) and myocardial blush grade (MBG) 0 to 1 (RR: 0.75; 95% CI: 0.58-0.99; p = 0.041). Furthermore, adenosine significantly reduced the risk of heart failure (RR: 0.66; 95% CI: 0.44-0.99; p = 0.044). Finally, adenosine use was associated with a lower creatine kinase-MB (CK-MB) peak value (weighted mean difference: -36.94; 95% CI: -73.76- -0.11; p = 0.049).
Conclusions:
This study revealed that adenosine use was associated with an increased incidence of ST resolution, and reduced risk of MACEs.
The Inplasy Registration:
INPLASY202510051, https://inplasy.com/inplasy-2025-1-0051/.
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