cAMP production secondary to A_2A adenosine receptor activation as a biomarker of ischemia-reperfusion process: A...

Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are standard revascularization strategies for chronic coronary syndrome (CCS). However, their effects on myocardial reperfusion have not been assessed using biological markers. Adenosine A_2A receptor (A_2AR) function on peripheral blood mononuclear cells (PBMCs), evaluated through cAMP production and EC₅₀-measurement, may reflect myocardial ischemia and reperfusion status.

To compare the effects of CABG and PCI on A_2AR pharmacological profiles assessed by cAMP-production (EC₅₀) values.

Ninety patients with severe coronary artery disease (33 CABG, 57 PCI) were prospectively included. Blood samples were collected before revascularization and 3 months later. PBMCs were incubated with a full A_2AR agonist, and cAMP production was measured.

Baseline EC₅₀ values were similar between PCI and CABG groups (0.072 ± 0.02 vs 0.078 ± 0.02 μM, p = 0.2). EC₅₀ significantly increased after PCI (+52%; 0.11 ± 0.04 μM, p < 0.001) and even more after CABG (+323%; 0.33 ± 0.08 μM, p < 0.0001).

Both PCI and CABG were associated with an increase in mean EC50 values, suggesting improved myocardial reperfusion. The greater EC₅₀ increase after CABG may indicate more complete restoration of coronary perfusion. A_2AR functional assessment may represent a non-invasive promising biomarker for monitoring chronic myocardial ischemia and revascularization efficacy in CCS patients.