Abstract:
BACKGROUND:Adenosine administered as an adjunct to reperfusion can reduce coronary no-reflow and limit myocardial infarct (MI) size in ST-segment elevation myocardial infarction (STEMI) patients. Whether adjunctive adenosine therapy can improve clinical outcomes in reperfused STEMI patients is not clear and is investigated in this meta-analysis of 13 randomized controlled trials (RCTs). METHODS:We performed an up-to-date search for all RCTs investigating adenosine as an adjunct to reperfusion in STEMI patients. We calculated pooled relative risks using a fixed-effect meta-analysis assessing the impact of adjunctive adenosine therapy on major clinical endpoint including all-cause mortality, non-fatal myocardial infarction, and heart failure. Surrogate markers of reperfusion were also analyzed. RESULTS:13 RCTs (4273 STEMI patients) were identified and divided into 2 subgroups: intracoronary adenosine versus control (8 RCTs) and intravenous adenosine versus control (5 RCTs). In patients administered intracoronary adenosine, the incidence of heart failure was significantly lower (risk ratio [RR] 0.44 [95% CI 0.25-0.78], P=0.005) and the incidence of coronary no-reflow was reduced (RR for TIMI flow<3 postreperfusion 0.68 [95% CI 0.47-0.99], P=0.04). There was no difference in heart failure incidence in the intravenous adenosine group but most RCTs in this subgroup were from the thrombolysis era. There was no difference in non-fatal MI or all-cause mortality in both subgroups. CONCLUSION:We find evidence of improved clinical outcome in terms of less heart failure in STEMI patients administered intracoronary adenosine as an adjunct to reperfusion. This finding will need to be confirmed in a large adequately powered prospective RCT.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Bulluck H,Sirker A,Loke YK,Garcia-Dorado D,Hausenloy DJdoi
10.1016/j.ijcard.2015.09.005subject
Has Abstractpub_date
2016-01-01 00:00:00pages
228-37eissn
0167-5273issn
1874-1754pii
S0167-5273(15)30446-0journal_volume
202pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Anemia is common in cardio-renal syndrome and may contribute to increase mortality. OBJECTIVE:To examine the prevalence of anemia and its relationship with cardio-renal syndrome, and to evaluate the risk factors for death. METHODS:Retrospective study with all patients admitted with congestive heart failure...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2006.10.005
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abstract::Presently, facilitated percutaneous coronary intervention (PCI) in patients remains controversial. We evaluated the efficacy and safety of facilitated PCI, intravenous low-dose rt-PA administration prior to urgent PCI, in Chinese patients < 70 years of age with ST-segment elevation myocardial infarction. Our results s...
journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
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journal_title:International journal of cardiology
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pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.08.037
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2009-02-20 00:00:00
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pub_type: 杂志文章
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更新日期:2013-10-09 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2010-07-09 00:00:00
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pub_type: 杂志文章
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2013-09-30 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ijcard.2014.10.029
更新日期:2014-12-20 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(92)90055-8
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journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1998-02-28 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2003.02.007
更新日期:2004-06-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
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更新日期:2013-10-30 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2008-07-04 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-03-15 00:00:00