cAMP production secondary to A2A adenosine receptor activation as a biomarker of ischemia-reperfusion process: A comparative pilot study between CABG and PCI.

BACKGROUND

Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are standard revascularization strategies for chronic coronary syndrome (CCS). However, their effects on myocardial reperfusion have not been assessed using biological markers. Adenosine A2A receptor (A2AR) function on peripheral blood mononuclear cells (PBMCs), evaluated through cAMP production and EC50-measurement, may reflect myocardial ischemia and reperfusion status.

OBJECTIVES

To compare the effects of CABG and PCI on A2AR pharmacological profiles assessed by cAMP-production (EC50) values.

METHODS

Ninety patients with severe coronary artery disease (33 CABG, 57 PCI) were prospectively included. Blood samples were collected before revascularization and 3 months later. PBMCs were incubated with a full A2AR agonist, and cAMP production was measured.

RESULTS

Baseline EC50 values were similar between PCI and CABG groups (0.072 ± 0.02 vs 0.078 ± 0.02 μM, p = 0.2). EC50 significantly increased after PCI (+52%; 0.11 ± 0.04 μM, p < 0.001) and even more after CABG (+323%; 0.33 ± 0.08 μM, p < 0.0001).

CONCLUSION

Both PCI and CABG were associated with an increase in mean EC50 values, suggesting improved myocardial reperfusion. The greater EC50 increase after CABG may indicate more complete restoration of coronary perfusion. A2AR functional assessment may represent a non-invasive promising biomarker for monitoring chronic myocardial ischemia and revascularization efficacy in CCS patients.