Skip Navigation



European Heart Journal Advance Access published online on June 16, 2006
European Heart Journal, doi:10.1093/eurheartj/ehl094
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
27/20/2400    most recent
ehl094v2
ehl094v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Kloner, R. A.
Right arrow Articles by Stone, G. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kloner, R. A.
Right arrow Articles by Stone, G. W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received March 25, 2006
Revised May 19, 2006
Accepted May 26, 2006

Clinical research

Impact of time to therapy and reperfusion modality on the efficacy of adenosine in acute myocardial infarction: the AMISTAD-2 trial

Robert A. Kloner 1 *, Mervyn B. Forman 2, Raymond J. Gibbons 3, Allan M. Ross 4, R. Wayne Alexander 5, and Gregg W. Stone 6

1 Heart Institute, Good Samaritan Hospital, Cardiovascular Division of the Keck School of Medicine at University of Southern California, 1225 Wilshire Boulevard, Los Angeles, CA 90017, USA
2 North Atlanta Cardiovascular Associates, P.C., Atlanta, Georgia; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
3 Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic, Rochester, MN, USA
4 Department of Medicine, George Washington University, Washington, DC, USA
5 Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
6 Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA

* To whom correspondence should be addressed.
Robert A. Kloner, E-mail: rkloner{at}goodsam.org


  Abstract

Aims The purpose of this analysis was to determine whether the efficacy of adenosine vs. placebo was dependent on the timing of reperfusion therapy in the second Acute Myocardial Infarction Study of Adenosine (AMISTAD-II).

Methods and results Patients presenting with ST-segment elevation anterior AMI were randomized to receive placebo vs. adenosine (50 or 70 µg/kg/min) for 3 h starting within 15 min of reperfusion therapy. In the present post hoc hypothesis generating study, the results were stratified according to the timing of reperfusion, i.e.  ≥ or < the median 3.17 h, and by reperfusion modality. In patients receiving reperfusion <3.17 h, adenosine compared with placebo significantly reduced 1-month mortality (5.2 vs. 9.2%, respectively, P = 0.014), 6-month mortality (7.3 vs. 11.2%, P = 0.033), and the occurrence of the primary 6-month composite clinical endpoint of death, in-hospital CHF, or rehospitalization for CHF at 6 months (12.0 vs. 17.2%, P = 0.022). Patients reperfused beyond 3 h did not benefit from adenosine.

Conclusion In this post hoc analysis, 3 h adenosine infusion administered as an adjunct to reperfusion therapy within the first 3.17 h onset of evolving anterior ST-segment elevation AMI enhanced early and late survival, and reduced the composite clinical endpoint of death or CHF at 6 months.

Keywords: Adenosine; Myocardial infarction; Thrombolysis; Fibrinolytic therapy; Percutaneous transluminal coronary angioplasty; Congestive heart failure.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Circ Cardiovasc IntervHome page
M. L. Fokkema, P. J. Vlaar, M. Vogelzang, Y. L. Gu, M. A. Kampinga, B. J. de Smet, G. A. Jessurun, R. L. Anthonio, A. F. van den Heuvel, E.-S. Tan, et al.
Effect of High-Dose Intracoronary Adenosine Administration During Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction: A Randomized Controlled Trial
Circ Cardiovasc Interv, August 1, 2009; 2(4): 323 - 329.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
K. R. Sipido, A. Tedgui, S. D. Kristensen, G. Pasterkamp, H. Schunkert, M. Wehling, P. G. Steg, W. Eisert, F. Rademakers, B. Casadei, et al.
Identifying needs and opportunities for advancing translational research in cardiovascular disease
Cardiovasc Res, August 1, 2009; 83(3): 425 - 435.
[Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
J. N. Peart and J. P. Headrick
Clinical cardioprotection and the value of conditioning responses
Am J Physiol Heart Circ Physiol, June 1, 2009; 296(6): H1705 - H1720.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll Cardiol IntvHome page
J. S. Forrester, A. J. White, S. Matsushita, T. Chakravarty, and R. R. Makkar
New Paradigms of Myocardial Regeneration Post-Infarction: Tissue Preservation, Cell Environment, and Pluripotent Cell Sources
J. Am. Coll. Cardiol. Intv., January 1, 2009; 2(1): 1 - 8.
[Abstract] [Full Text] [PDF]

Home page
 Cardiovasc ResHome page
E. Velot, B. Haas, F. Leonard, I. Ernens, M. Rolland-Turner, C. Schwartz, D. Longrois, Y. Devaux, and D. R. Wagner
Activation of the adenosine-A3 receptor stimulates matrix metalloproteinase-9 secretion by macrophages
Cardiovasc Res, November 1, 2008; 80(2): 246 - 254.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
G. W. Stone
Angioplasty Strategies in ST-Segment-Elevation Myocardial Infarction: Part II: Intervention After Fibrinolytic Therapy, Integrated Treatment Recommendations, and Future Directions
Circulation, July 29, 2008; 118(5): 552 - 566.
[Full Text] [PDF]

Home page
 CirculationHome page
R. A. Kloner and R. W. Nesto
Glucose-Insulin-Potassium for Acute Myocardial Infarction: Continuing Controversy Over Cardioprotection
Circulation, May 13, 2008; 117(19): 2523 - 2533.
[Full Text] [PDF]

Home page
 NEJMHome page
R. Ramaraj, M. B. Forman, E. K. Jackson, C. J. Lowenstein, B. Ibanez, G. Cimmino, J. J. Badimon, P. G. Korantzopoulos, J. A. Goudevenos, D. M. Yellon, et al.
Myocardial Reperfusion Injury
N. Engl. J. Med., December 6, 2007; 357(23): 2408 - 2410.
[Full Text] [PDF]

Home page
 NEJMHome page
D. M. Yellon and D. J. Hausenloy
Myocardial Reperfusion Injury
N. Engl. J. Med., September 13, 2007; 357(11): 1121 - 1135.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
C. B. Granger and M. R. Patel
The Search for Myocardial Protection: Is There Still Hope?
J. Am. Coll. Cardiol., July 31, 2007; 50(5): 406 - 408.
[Full Text] [PDF]

Home page
 Cardiovasc ResHome page
M. T. Dirksen, G. J. Laarman, M. L. Simoons, and D. J.G.M. Duncker
Reperfusion injury in humans: A review of clinical trials on reperfusion injury inhibitory strategies
Cardiovasc Res, June 1, 2007; 74(3): 343 - 355.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
The APEX AMI Investigators
Pexelizumab for Acute ST-Elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial
JAMA, January 3, 2007; 297(1): 43 - 51.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
G. Maurer
Adenosine as an adjunct to reperfusion in myocardial infarction
Eur. Heart J., October 2, 2006; 27(20): 2376 - 2377.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.