Adenosine For Acute Myocardial Infarct Participants Undergoing Primary Percutaneous Coronay Intervention:a Meta-analysis

Objective:To study the impact of adenosine on acute myocardial infarct (AMI) patients who are undergoing PPCI.Method:Only randomized controlled trials (RCT) will be selected by searching Cochrane Library, Medline, Embase and CNKI databases. We identified7RCTs involving761patients with AMI for PPCI where the primary intention was to study the impact of adenosine. Quality assessment, data extraction and analysis were performed by two reviewers independently.Result:After pooled analysis, we found no strong evidence that adenosine reduced total mortality (RR0.64,95%CI0.22to1.85, P=0.41) and non fatal myocardial infarction (RR1.38,95%0.28to6.96, P=0.69) during one month follow up period. TIMI flow grade≤2was measured in711participants from6included studies by coronary angiogram after reperfusion (PPCI), there were strong evidence to prove that the adenosine can reduce the incidence of TIMI flow grade≤2(RR0.61,95%CI0.38to0.97, P=0.04). Regarding MBG0to1, only two trials included involving518participants, the result did not favor the adenosine in reduction of the occurrence of MBG0to1(RR0.98,95%CI 0.75to1.29, P=0.91) which was measured just after reperfusion by PPCI. There were4studies included involving561patients for STR>50%outcome which was measured60minutes after the procedure. But, the result showed that there were no statistically difference between adenosine and control (RR1.30,95%CI0.90to1.87, P=0.16), in addition, statistic heterogeneity was observed (P=68%, P=0.03).Conclusion:In accordance with the current review, we found out that adenosine as an adjunctive to PPCI can reduce the incidence of angiographic no reflow(TIMI flow grade≤2).