Adenosine given before primary PCI to reduce no-reflow in STEMI patients.
Adenosine Pre-Medication in Primary Percutaneous Coronary Intervention: A Randomized Control Trial
See if giving intracoronary adenosine before primary PCI lowers the chance of slow flow/no-reflow in adults with STEMI.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 1148 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | National Institute of Cardiovascular Diseases, Pakistan Academic / other |
| Locations | 2 sites (Karachi, Sindh and 1 other locations) |
| Trial ID | NCT07536802 on ClinicalTrials.gov |
What this trial studies
This is a multicenter, single-blinded, randomized study enrolling 1,148 adults with STEMI undergoing primary PCI and randomizing them 1:1 to intracoronary adenosine pre-medication or standard care. The intervention uses weight-independent intracoronary doses (2 mg for left coronary, 1 mg for right, diluted) administered before reperfusion. The primary outcome is incidence of slow flow/no-reflow by TIMI flow grade, with myocardial blush grade as a secondary outcome. Key exclusions include cardiogenic shock, heart block, and known adenosine allergy.
Who should consider this trial
Good fit: Adults aged 18 or older presenting with STEMI who are planned for primary PCI and can provide consent are the ideal candidates.
Not a fit: Patients with cardiogenic shock, heart block, or a known allergy to adenosine are excluded and would not be expected to benefit from this intervention.
Why it matters
Potential benefit: If successful, giving adenosine before PCI could improve microvascular blood flow and reduce heart muscle damage after STEMI.
How similar studies have performed: Adenosine has been used during PCI and prior small studies report mixed effects on microvascular perfusion, so prophylactic pre-medication is plausible but not yet definitively proven.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * All patients with acute STEMI undergoing primary PCI * Patients of either sex, ≥18 years of age. Exclusion Criteria: * STEMI patients with cardiogenic shock at presentation * Patients with heart block * Allergy to adenosine * Patients refuse to give consent for participation
Where this trial is running
Karachi, Sindh and 1 other locations
- National Institute of Cardiovascular Diseases — Karachi, Sindh, Pakistan (Recruiting)
- National Institute of Cardiovascular Diseases — Karachi, Sindh, Pakistan (Recruiting)
Study contacts
- Principal investigator: Muhammad Nauman, FCPS — National Institute of Cardiovascular Diseases
- Study coordinator: Muhammad Nauman Khan, FCPS
- Email: nkhan116@yahoo.com
- Phone: +923453549634
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.