Key result
Low-dose intracoronary adenosine accurately detects abnormal IV adenosine-derived CFR with ~0.97 AUC.
Why the study?
Intravenous adenosine infusion is the reference for assessing coronary microvascular function but has systemic side effects and logistical limitations, prompting investigation of intracoronary adenosine as an alternative.
Does intracoronary adenosine provide feasible and diagnostic indices of microvascular function compared to intravenous adenosine?
Observational (n=76)
Yes
Does intracoronary adenosine provide feasible and diagnostic indices of microvascular function compared to intravenous adenosine?
Intracoronary adenosine may offer a faster, better-tolerated alternative to intravenous adenosine for assessing coronary microvascular function during invasive angiography.
Answers are grounded in this paper and cite their sources.
May support faster microvascular testing in the cath lab; leaves open prospective validation before practice change.
oronary microvascular dysfunction causes myocardial ischemia with no obstructive coronary artery disease, 1 angina, and impaired quality of life. 2 Coronary function testing undertaken during invasive coronary angiography may aid diagnosis. 3 Intravenous adenosine infusion for the induction of stable hyperemia is the reference approach for assessing microvascular function. 3 However, systemic side effects, logistics, and cost limit clinical adoption. 4 Intracoro-nary adenosine (low-dose defined as < 100 µg) represents an alternative method for achieving myocardial hyperemia, with fewer side effects and improvements in logistics. 4,5 Furthermore, the onset of hyperemia is faster ( < 5 seconds) after intracoronary adenosine compared with intravenous infusion (1–2 minutes). 4,5 Accordingly, we investigated the feasibility and diagnostic value of intracoronary adenosine– derived indices of microvascular function. We performed
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Ang et al. (2024) conducted an observational in Suspected angina (n=76). Intracoronary adenosine vs. Intravenous adenosine infusion (140 µg/kg per min) was evaluated on Accuracy of low-dose intracoronary adenosine coronary flow reserve (CFR) for predicting intravenous adenosine CFR <2.0 (AUC 0.97, 95% CI 0.94-1.00). Low-dose intracoronary adenosine demonstrated high diagnostic accuracy for predicting abnormal intravenous adenosine-derived coronary flow reserve with an AUC of 0.97.
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