Volume 44 Issue 6
Jun.  2023
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Jie FANG, Xuefeng GUANG, Hailong DAI, Xiaofeng LIN, Xuming ZHANG, Qi LAI. Preventive Effect of Adenosine for No-reflow Phenomenon in Patients with Acute Non-ST-segment Elevation Myocardial Infarction[J]. Journal of Kunming Medical University, 2023, 44(6): 70-75. doi: 10.12259/j.issn.2095-610X.S20230604
Citation: Jie FANG, Xuefeng GUANG, Hailong DAI, Xiaofeng LIN, Xuming ZHANG, Qi LAI. Preventive Effect of Adenosine for No-reflow Phenomenon in Patients with Acute Non-ST-segment Elevation Myocardial Infarction[J]. Journal of Kunming Medical University, 2023, 44(6): 70-75. doi: 10.12259/j.issn.2095-610X.S20230604

Preventive Effect of Adenosine for No-reflow Phenomenon in Patients with Acute Non-ST-segment Elevation Myocardial Infarction

doi: 10.12259/j.issn.2095-610X.S20230604
  • Received Date: 2023-03-19
  • Publish Date: 2023-06-25
  •   Objective   To study the effect of intracoronary injection of adenosine for the prevention of no-reflow phenomenon (NRP) before balloon dilation and stent placement during primary percutaneous coronary intervention (PPCI) in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI).   Methods   A prospective randomized controlled design was used to select 196 NSTEMI patients who received PPCI in the Department of Cardiology, Yan’an Hospital, from January 2020 to June 2022. Randomized number table method was used to divide the patients into two groups, with 98 patients in each group. Patients in one group were treated with intracoronary injection of 100 μg adenosine prophylactically before stent placement or balloon dilation; while patents in another group were given 100 ug adenosine after stent placement if NRP happened. At the end of PPCI, the incidence of myocardial infarction thrombolysis test (TIMI) blood grading, myocardial TIMI perfusion grading (TMPG), myocardial staining grading (MBG) and NRP were examined.   Results   After stent placement, 89.6% of patients in the prophylactic administration group had blood flow TIMI, TMPG and MBG grades of infarct-related vessels reaching grade 3, and 73.4% in the remedial administration group, with statistical significance (P < 0.05). The incidence of NRP was 8.2% in the prophylactic group and the incidence was 23.6% in the remedial administration group, with statistical significance ( P < 0.05). TIMI, TMPG and MBG grade 3 blood flow were restored in all patients presented with NRP after intracoronary injection of adenosine.   Conclusion   For indicated patients with NSTEMI, prophylactical intracoronary injection of adenosine before stent implantation can reduce the incidence of NRP significantly after stent placement.
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