Prophylactic Intra-coronary Adenosine to Prevent Post Coronary Artery Stenting Myonecrosis
Status:
Terminated
Trial end date:
2008-09-01
Target enrollment:
Participant gender:
Summary
Myocardial damage occurs in up to 40% of cases when sensitive biomarkers are measured after
coronary artery stenting. Such events have been associated with poor outcomes both at 30 days
and long term. The cause of such damage is multi-factorial and includes distal propagation of
atheromatous and thrombotic debris and the subsequent infiltration of the microcirculation
with inflammatory cells. Individually or together these events can occlude the
micro-circulation and lead impaired blood flow to heart muscle.
The vasodilator adenosine is commonly used in cases of impaired flow in an endeavor to
improve flow rate and limit myocardial damage. Unfortunately the efficacy of this therapy is
limited. More recently, there have been clinical studies looking at the administration of
adenosine before any potential damage by ballooning or stenting, in an effort to avoid poor
distal flow post procedure and thus limit any myocardial damage. Although small numbers of
subjects have been included in these trials, there have been encouraging preliminary data.
The aim of this study is to assess whether the use of intra-coronary adenosine given directly
into the target coronary artery prior to stenting can reduce the incidence of myonecrosis
(heart muscle damage)over placebo. We also aim to assess whether this translates to better
outcomes at 30 day follow up.