Cardioprotective effects of intracoronary adenosine in diabetic patients undergoing elective percutaneous coronary intervention.

AIM: Myocardial injury commonly occurs during percutaneous coronary intervention (PCI). Several agents that mimic ischemic preconditioning could help minimize this phenomenon. This study evaluated the cardio-protective role of intracoronary Adenosine in elective PCI.

METHODS

A total of 100 diabetic patients with chronic stable angina were prospectively enrolled, then randomly assigned to undergo PCI with intracoronary Adenosine; 100 µg/stented vessel (group-A, 50 patients) or standard PCI (group-B, 50 patients). Cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) levels were measured before and 6, 12 and 24 hours post-PCI.

RESULTS

Mean age of the study cohort was 57±8 years (males=63%). cTnI level was significantly lower in group-A (6 hours: 7.5±0.2 vs. 15.5±0.5 pg/mL, 12 hours: 13.7±0.7 vs. 25.5±0.6 pg/mL and 24 hours: 7.6±0.5 vs. 16±0.3 pg/mL, P<0.001). After 3 months, the same group showed significantly higher left ventricle ejection fraction (LVEF %), i.e. 64.5±5.7 vs. 56.5±5.3 (P<0.05). There was no statistically significant difference between both groups of patients regarding incidence of major adverse cardiac events (MACE).

CONCLUSION

In diabetic patients undergoing elective PCI, intracoronary Adenosine was associated with decreased incidence of PCI-related myocardial injury & improvement of LVEF% after 3 months.