Evaluating Adenosine Pre-Medication to Improve Blood Flow During Primary PCI for STEMI A Randomized Controlled Phase 4 Study in Adults 18 to 80 Years

What this Trial Is About

Researchers are evaluating the effect of adenosine pre-medication on the occurrence of slow flow or no-reflow after primary percutaneous coronary intervention PCI in adults with ST-segment elevation myocardial infarction STEMI. This study is a randomized controlled trial involving 1,148 patients, designed to assess whether giving adenosine before PCI can improve heart muscle blood flow and reduce complications associated with inadequate myocardial perfusion. Participants will be randomly assigned to one of two groups one group will receive intracoronary adenosine before PCI along with standard pharmacological treatment, while the control group will receive only standard care during PCI. The adenosine dose is 2 mg for the left coronary artery and 1 mg for the right coronary artery, diluted in 20 mL normal saline, administered immediately before the procedure. The study will take place over 12 months at multiple centers. During the study, researchers will collect baseline and procedural data, monitoring the incidence of slow flow or no-reflow using TIMI flow grades during the PCI procedure. They will also assess myocardial perfusion through the Myocardial Blush Grade. Safety will be monitored for potential side effects such as transient bradycardia or heart block. Statistical analysis will evaluate the outcomes, and participants will be followed until the study concludes at the end of 2026.

Adenosine Pre-Medication in Primary Percutaneous Coronary Intervention