Intracoronary adenosine administered during percutaneous intervention in acute myocardial infarction and reduction in the incidence of "no reflow" phenomenon

Percutaneous intervention in acute myocardial infarction has been associate d with a high incidence of "no reflow," ranging from 11% to 30%, with an in creased risk of complications. The role of intracoronary adenosine for the prevention of this phenomenon has not been evaluated fully. We studied the procedural outcomes of 79 patients who underwent percutaneous intervention in the context of acute myocardial infarction. Twenty-eight patients receiv ed no intracoronary adenosine, and 51 received intracoronary adenosine bolu ses (24-48 mu g before and after each balloon inflation). Eight patients wh o were not given adenosine experienced no reflow (28.6%) and higher rates o f in-hospital death, while only three of 51 patients (5.9%; P = 0.014) in t he adenosine group experienced no reflow. No untoward complications were no ted during adenosine infusion. Intracoronary adenosine bolus administration during percutaneous intervention in the context of acute myocardial infarc tion is easy and safe and may significantly lessen the incidence of no refl ow, which may improve the outcome of this procedure. Cathet Cardiovasc. Int ervent. 51:27-31, 2000. (C) 2000 Wiley-Liss, Inc.