What is the clinical evidence from this study?

Study design: Other. Population: Normal epicardial coronary arteries (n=27). Intervention: Adenosine triphosphate (ATP) vs. Papaverine. Primary outcome: Coronary and systemic hemodynamics and electrocardiogram (ECG) variables.

What does this research mean for the field?

Intracoronary administration of adenosine triphosphate (ATP) safely achieves maximal coronary vasodilation comparable to papaverine, whereas intravenous infusion achieves near-maximal hyperemia but causes serious hypotension in a significant portion of patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 1998Open Access

Effect of Adenosine Triphosphate on Human Coronary Circulation.

NSNobuo ShiodeHiroshima City Asa Citizens Hospital MKMasaya KatoHiroshima University KNKensho NakayamaHiroshima University

Key Result

Intracoronary ATP safely achieved maximal coronary vasodilation similar to papaverine, whereas intravenous infusion caused near-maximal hyperemia but serious hypotension in 40% of patients.

Structured PICO

Does adenosine triphosphate (ATP) safely induce maximal coronary hyperemia compared to papaverine in patients with normal coronary arteries?

Population

27 patients (12 in intracoronary bolus group, 15 in intravenous infusion group) with normal epicardial coronary arteries undergoing coronary angiography for chest pain syndrome.

Intervention

Adenosine triphosphate (ATP) administered by intracoronary bolus (4-16 μg) or intravenous infusion (25-200 μg/kg/min).

Comparator

Intracoronary papaverine (10 mg) and 0.9% saline.

Outcome

Coronary blood flow velocity (CBFV) and coronary vascular resistance index (CVRi).surrogate

Intracoronary ATP is a safe and effective alternative to papaverine for inducing maximal coronary hyperemia during catheterization, avoiding the risk of QT prolongation.

Abstract

We investigated in humans the effects of adenosine triphosphate (ATP), administered by intracoronary bolus (4-16 microg) or intravenous infusion (25-200 microg/kg/min), on coronary and systemic hemodynamics and electrocardiogram (ECG) variables. All patients had normal epicardial coronary arteries. The maximal coronary blood flow velocity (CBFV) was determined with intracoronary bolus of papaverine. A 12 microg bolus of ATP (n=12) caused maximal coronary hyperemia similar to that caused by papaverine. Intracoronary boluses caused a small brief decrease in arterial pressure but no significant changes in HR or ECG variables. Intravenous infusion of ATP at 150 microg/kg/min (n=15) caused a decrease in the coronary resistance index similar to that caused by papaverine, but the rate of increase in CBFV by ATP was smaller than that caused by papaverine. No patients had a significant change in ECG variables, but some patients (40%) had a serious decrease in arterial pressure. These studies suggest that maximal coronary vasodilation can be achieved safely with intracoronary ATP administration and that intravenous infusions at 150 microg/kg/min cause near-maximal coronary hyperemia in most patients.

Perguntar à IA

Bookmark

View Full Paper

Cite This Study

Shiode et al. (Thu,) conducted a other in Normal epicardial coronary arteries (n=27). Adenosine triphosphate (ATP) vs. Papaverine was evaluated on Coronary and systemic hemodynamics and electrocardiogram (ECG) variables. Intracoronary ATP safely achieved maximal coronary vasodilation similar to papaverine, whereas intravenous infusion caused near-maximal hyperemia but serious hypotension in 40% of patients.

synapsesocial.com/papers/6a158d0037103a43379fe576 https://doi.org/https://doi.org/10.2169/internalmedicine.37.818

Perguntar à IA

Bookmark

View Full Paper