caa a22 4500 606158693 CHVBK 20210128100621.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s10557-015-6606-5 doi (NATIONALLICENCE)springer-10.1007/s10557-015-6606-5 Adenosine as an Adjunct Therapy in ST Elevation Myocardial Infarction Patients: Myth or Truth? [Elektronische Daten] [George Kassimis, Periklis Davlouros, Niket Patel, Gianluigi De Maria, Manolis Kallistratos, Rajesh Kharbanda, Athanasios Manolis, Dimitrios Alexopoulos, Adrian Banning] Early reperfusion represents the key strategy in ST elevation myocardial infarction. However, reperfusion may induce myocardial damage due to the reperfusion myocardial injury, compromising the full potential of reperfusion therapy and accounting for unfavourable results in high risk patients. Adenosine seems to attenuate ischemia reperfusion injury, and thus represents a promising therapeutic option for treating such patients. However, previous randomized clinical trials have collectively failed to demonstrate whether adenosine can effectively reduce measures of myocardial injury and improve clinical outcome, despite its good basic evidence. The failure of such trials to show a real beneficial action may be in part related to specific factors other than adenosine's clinical efficacy. The purpose of this review is to explain the rationale for the use of adenosine as an adjunctive pharmacological cardio-protective agent following reperfusion of the ischemic myocardium, to address the weakness of previous trials and to summarize the current state of knowledge regarding the effect of adenosine administration on reperfusion myocardial injury in patients with myocardial infarction. Although some preclinical and clinical studies point towards the beneficial role of adenosine in the prevention and treatment of no-reflow phenomenon in myocardial infarction, many unanswered questions still remain, including the optimal clinical indication, mode, dosage, duration and timing of application, and the exact mechanisms leading to potential benefits. Clarifying these issues will depend on further properly designed, adequately powered and well conducted clinical trials, which will probably provide us with the definite answers. Springer Science+Business Media New York, 2015 Adenosine nationallicence ST elevation myocardial infarction nationallicence No-reflow nationallicence Microvascular obstruction nationallicence Reperfusion injury nationallicence Kassimis George Department of Cardiology, Asklepeion General Hospital, Athens, Greece aut Davlouros Periklis Department of Cardiology, University Hospital of Patras, Rion, Greece aut Patel Niket Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut De Maria Gianluigi Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut Kallistratos Manolis Department of Cardiology, Asklepeion General Hospital, Athens, Greece aut Kharbanda Rajesh Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut Manolis Athanasios Department of Cardiology, Asklepeion General Hospital, Athens, Greece aut Alexopoulos Dimitrios Department of Cardiology, University Hospital of Patras, Rion, Greece aut Banning Adrian Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/5(2015-10-01), 481-493 0920-3206 29:5<481 2015 29 10557 https://doi.org/10.1007/s10557-015-6606-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10557-015-6606-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kassimis George Department of Cardiology, Asklepeion General Hospital, Athens, Greece aut NATIONALLICENCE 700 1- Davlouros Periklis Department of Cardiology, University Hospital of Patras, Rion, Greece aut NATIONALLICENCE 700 1- Patel Niket Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut NATIONALLICENCE 700 1- De Maria Gianluigi Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut NATIONALLICENCE 700 1- Kallistratos Manolis Department of Cardiology, Asklepeion General Hospital, Athens, Greece aut NATIONALLICENCE 700 1- Kharbanda Rajesh Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut NATIONALLICENCE 700 1- Manolis Athanasios Department of Cardiology, Asklepeion General Hospital, Athens, Greece aut NATIONALLICENCE 700 1- Alexopoulos Dimitrios Department of Cardiology, University Hospital of Patras, Rion, Greece aut NATIONALLICENCE 700 1- Banning Adrian Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Springer US; http://www.springer-ny.com 29/5(2015-10-01), 481-493 0920-3206 29:5<481 2015 29 10557