Aims: To examine the effect of intracoronary adenosine administration on angiographic and procedural outcomes of percutaneous coronary intervention (PCI) in patients with documented chronic total occlusions (CTO).
Methods and results: A prospective, single-center, placebo-controlled study was conducted on 96 patients with CTO. Patients were divided in two groups, receiving either adenosine or placebo by intracoronary administration prior to PCI. Group I received 10 mg of adenosine bolus before wiring of each lesion (n=51) and group II received placebo (n=45). The parameters examined were the length of the stent segment, residual stenosis, procedural success and restoration of TIMI 3 and TIMI 2 flow grades. Prior to PCI, the analysed parameters did not differ significantly in all patients in the study. After the surgery, a difference between the groups was observed in all parameters under investigation. The length of the stent segment was 27.23±1.13 mm in the adenosine group (group I) vs. 32.23±11.8 mm in the placebo group (group II), (p<0.05). The value of residual stenosis was 0.30±0.03 mm (group I) vs. 0.35±0.2 mm (group II), (ð<0.05). The procedural success was 90.1% (group I) vs. 71.12% (group II), (p<0.05). Restoration of TIMI 3 flow was 92% (group I) vs. 68.9% (group II), (p<0.05) and TIMI 2 flow restoration was 7.84% vs. 31.11% in groups I and II, respectively (p<0.05). In terms of technical success, no significant difference was detected between the groups, indicating homogeneity across both groups of patients.
Conclusions: Intracoronary adenosine appeared to reduce myocardial infarction associated with PCI as a trigger of ischemic preconditioning, as well as improving angiographic results.