Key result
Intracoronary adenosine pretreatment reduced the incidence of myonecrosis after elective PCI from 36.7% to 16.7% compared to no pretreatment, though the result was not statistically significant (OR 1.818, p=0.080).
Why the study?
Appearance of serum CK-MB after successful PCI reflects periprocedural myonecrosis associated with future cardiac adverse events, but the effect of intracoronary adenosine on myonecrosis incidence after elective PCI was unclear.
Does intracoronary adenosine reduce the incidence of periprocedural myonecrosis in patients undergoing elective PCI?
Case-Control (n=60)
No
Does intracoronary adenosine reduce the incidence of periprocedural myonecrosis in patients undergoing elective PCI?
Intracoronary adenosine prior to elective PCI showed a non-statistically significant trend towards reducing periprocedural myonecrosis.
Answers are grounded in this paper and cite their sources.
Loading...
Trend toward less myonecrosis with adenosine does not support routine use; leaves open benefit in larger trials.
Appearance of serum creatine kinase MB fraction (CK-MB), reflecting the periprocedural myonecrosis, after successful percutaneous coronary intervention (PCI) is associated with future cardiac adverse events. The intracoronary adenosine on the incidence of myonecrosis after elective PCI was assessed. In this prospective, case control study with a total of 60 patients, 30 cases pretreated with 50 micro grams bolus intracoronary adenosine before advancement of guidewire and 30 controls not pretreated was studied during elective PCI. Both groups received statin and loading dose of Clopidogrel. Myonecrosis was assessed by CK-MB level after PCI. Post procedural myonecrosis occurred in 16.7 % (n=5) in case group and 36.7 % (n=11) in control group (OR=1.818; 95% CI 0.841; P=0.080). The result is not statistically significant but shows that the incidence of myonecrosis was reduced from 36.7% to 16.7%. Intracoronary adenosine reduces the incidence of myonecrosis after elective PCI. Keywords: Adenosine; Creatine kinase MB fraction; Intracoronary; Myonecrosis; Percutaneous coronary intervention; Periprocedural. doi:10.3329/uhj.v4i2.2068 University Heart Journal Vol. 4 No. 2 July 2008 p19-23
Ahsan et al. (2009) conducted a case-control in Elective percutaneous coronary intervention (n=60). Intracoronary Adenosine vs. No pretreatment was evaluated on Incidence of myonecrosis (elevation of CK-MB above 25 IU/L) (OR 1.818, 95% CI 0.841, p=0.080). Intracoronary adenosine pretreatment reduced the incidence of myonecrosis after elective PCI from 36.7% to 16.7% compared to no pretreatment, though the result was not statistically significant (OR 1.818, p=0.080).