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.