SynthesisInternational journal of cardiology2016
Clinical benefit of adenosine as an adjunct to reperfusion in ST-elevation myocardial infarction patients: An updated meta-analysis of randomized controlled trials.
Synthesis in International journal of cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Microcirculation function assessment in acute myocardial infarction: A systematic review of microcirculatory resistance indices.Frontiers in cardiovascular medicine · 2022Pooled it
- Angiographic predictors of outcome in myocardial infarction patients presenting with cardiogenic shock: a CULPRIT-SHOCK angiographic substudy.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Trial
- Historical account of reperfusion therapy and the development of cardioprotection beyond reperfusion.Basic research in cardiology · 2026Review
- Toll-like receptor 7 constrains efferocytosis in myocardial injury.Basic research in cardiology · 2026Article
- Reperfusion injury from a haemodynamic standpoint and role of pressure-controlled reperfusion in avoiding reperfusion injury.European heart journal open · 2026Review
- Review
- Xanthosine alleviates myocardial ischemia-reperfusion injury through attenuation of cardiomyocyte ferroptosis.Cellular & molecular biology letters · 2025Article
- Molecular Mechanisms of Microvascular Obstruction and Dysfunction in Percutaneous Coronary Interventions: From Pathophysiology to Therapeutics-A Comprehensive Review.International journal of molecular sciences · 2025Review
- Pericytes in the brain and heart: functional roles and response to ischaemia and reperfusion.Cardiovascular research · 2025Review
- Article
- Coronary microvascular obstruction and dysfunction in patients with acute myocardial infarction.Nature reviews. Cardiology · 2024Review
- Health position paper and redox perspectives on reactive oxygen species as signals and targets of cardioprotection.Redox biology · 2023Review
- Recombinant Apyrase (AZD3366) Against Myocardial Reperfusion Injury.Cardiovascular drugs and therapy · 2023Article
- Adenosine signaling as target in cardiovascular pharmacology.Current opinion in pharmacology · 2023Review
- Assessment of Squalene-Adenosine Nanoparticles in Two Rodent Models of Cardiac Ischemia-Reperfusion.Pharmaceutics · 2023Article
- Purinergic signaling in myocardial ischemia-reperfusion injury.Purinergic signalling · 2023Review
- Complementary Pharmacotherapy for STEMI Undergoing Primary PCI: An Evidence-Based Clinical Approach.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022Review
- Identification of metabolic pathways underlying FGF1 and CHIR99021-mediated cardioprotection.iScience · 2022Article
- A fresh look at coronary microembolization.Nature reviews. Cardiology · 2022Review
- Adenosine in Acute Myocardial Infarction-Associated Reperfusion Injury: Does it Still Have a Role?Frontiers in pharmacology · 2022Review
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundAdenosine 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).
methodsWe 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.
results13 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.
conclusionWe 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.