Objective: There are several reports of the use of
adenosine as a cardioprotective agent during cardiac surgery. Adenosine
treatment might affect neutrophils and inflammatory mediators. The
present prospective randomized study was designed to investigate the
effect of adenosine pretreatment on myocardial recovery and
inflammatory response in patients undergoing elective coronary artery
Design: A prospective, randomized,
Setting: Operative unit and ICU in a
university hospital in Finland.
Patients: Thirty male
patients undergoing primary, elective coronary revascularization.
Interventions: Patients in the adenosine group received a
7-min infusion of adenosine (total, 650 μg/kg) before the initiation
of cardiopulmonary bypass.
creatine kinase (CK)-MB release and hemodynamics were recorded.
Perioperative leukocyte and cytokine release were measured.
Results: Adenosine pretreatment resulted in less CK-MB
release and an improved postbypass cardiac index. Similar leukocyte
counts and cytokine responses were seen in both groups perioperatively.
Neutrophil counts were similar between the groups before and after
myocardial ischemia when measured simultaneously in arterial and
coronary sinus blood.
Conclusions: The present results
support the hypothesis that adenosine pretreatment is cardioprotective
in humans, but the present dose failed to regulate the inflammatory
responses after coronary artery bypass grafting.