Kızılırmak, FilizGüneş, Hacı MuratDemir, Gültekin GünhanGökdeniz, TayyarGüler, EkremÇakal, BeytullahOmaygenç, Mehmet OnurYılmaz, FatihSavur, ÜmeyirBarutçu, İrfan10.07.20192019-07-1010.07.20192019-07-102015Kızılırmak, F., Güneş, H. M., Demir, G. G., Gökdeniz, T., Gökdeniz, T., Güler, E. ... Barutçu, İ. (2015). Impact of intracoronary adenosine on myonecrosis in patients with unstable angina pectoris undergoing percutaneous coronary intervention. Cardiovascular Drugs and Therapy, 29(6), 519-526. https://dx.doi.org/10.1007/s10557-015-6631-40920-32061573-7241https://dx.doi.org/10.1007/s10557-015-6631-4https://hdl.handle.net/20.500.12511/2124WOS: 000368454100003PubMed ID: 26631392Background In this study, we aimed to investigate the impact of prophylactic intracoronary adenosine administered during percutaneous coronary intervention (PCI) due to unstable angina pectoris on myonecrosis by measuring post-procedural levels of cardiac troponin I (cTnI) and creatine kinase-myocardial band (CK-MB). Methods A total of 122 patients with unstable angina undergoing PCI were included in this single-center, double-blind, randomized study. The patients were randomly allocated to adenosine and placebo groups. In the adenosine group, a single-dose of intracoronary adenosine (100 mu g for the right coronary artery and 150 mu g for the left coronary artery) was administered. Primary endpoint was post-PCI myonecrosis, which was defined as abnormal levels of periprocedural cTnI. Secondary endpoints were defined as elevated cTnI levels [5 x upper limit of normal (ULN)], abnormal CK-MB levels, angiographic coronary flow measured by Thrombolysis In Myocardial Infarction (TIMI) frame count (TFC), the cumulative incidence of in-hospital death and in-hospital urgent target vessel revascularization (TVR). Results Clinical and angiographic characteristics of both adenosine (61 patients, 61 +/- 9 years) and placebo (61 patients, 59 +/- 10 years) groups were similar (p > 0.05 for all). Post-procedural abnormal cTnI levels in the adenosine group were significantly lower than the placebo group (32 % vs. 55 %, p: 0.011). cTnI > 5 x ULN (21 % vs. 31 %, p: 0.217) and abnormal CK-MB levels (11 % vs. 19 %, p: 0.263) were similar in both groups. Post-procedural TFCs in the adenosine group were significantly lower than the placebo group (24 +/- 4 vs. 27 +/- 5, p: 0.004). In-hospital events including death and urgent TVR were not observed in either group. Conclusion Intracoronary administration of single-dose adenosine in patients with unstable angina undergoing PCI is associated with decreased periprocedural myonecrosis and improved coronary blood flow.eninfo:eu-repo/semantics/embargoedAccessMyonecrosisAdenosinePercutaneous Coronary InterventionUnstable AnginaArticle29651952610.1007/s10557-015-6631-4Q2Q1