Key result
Continuous intracoronary adenosine infusion achieves lower FFR than bolus injection, matching intravenous delivery.
Why the study?
Maximal vasodilatation is mandatory for valid CFR and FFR measurements, but the optimal adenosine dose and administration method in Koreans is unclear.
Does the dosage and method of adenosine administration affect the measurement of coronary flow reserve and fractional flow reserve in Korean patients?
Comparison
Different doses and methods of adenosine administration compared
Design
Cohort study with phase I and phase II components
Authors
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Optimal IC adenosine boluses (40 µg LAD, 20 µg RCA) may suffice for FFR in Koreans; leaves open need for larger randomized validation.
Does the dosage and method of adenosine administration affect the measurement of coronary flow reserve and fractional flow reserve in Korean patients?
Absolute Event Rate: 0.78% vs 0.83%
p-value: p=<0.01
An intracoronary bolus of 40 μg for the left coronary artery and 20 μg for the right coronary artery is generally optimal for FFR measurement, though continuous infusion or higher bolus doses may be necessary for borderline lesions to ensure maximal hyperemia.
Suh et al. (2006) studied Coronary artery disease (intermediate lesions) or normal coronary arteries (n=177). Adenosine vs. Different doses and routes of adenosine administration was evaluated on Fractional flow reserve (FFR) at maximal hyperemia (p=<0.01). Intracoronary continuous infusion of adenosine achieved significantly lower FFR values (0.78) compared to intracoronary bolus injection (0.83, p<0.01), and was comparable to intravenous infusion.
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