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This article has been retracted upon the authors' request, as it was found to include erroneous data that their findings and conclusions cannot be relied upon. Additionally, the article was submitted for publication by the author Gemina Doolub without the knowledge and approval of the other author Erica Dall'Armellina.

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  1. G. Doolub and E. Dall'Armellina, “Intracoronary adenosine versus intravenous adenosine during primary PCI for ST-elevation myocardial infarction: which one offers better outcomes in terms of microvascular obstruction?” ISRN Cardiology, vol. 2013, Article ID 248476, 8 pages, 2013.
ISRN Cardiology
Volume 2013, Article ID 248476, 8 pages
Clinical Study

Intracoronary Adenosine versus Intravenous Adenosine during Primary PCI for ST-Elevation Myocardial Infarction: Which One Offers Better Outcomes in terms of Microvascular Obstruction?

1Cardiology Department, John Radcliffe Hospital, Oxford OX3 9DU, UK
2Oxford Centre for Clinical Magnetic Resonance, John Radcliffe Hospital, Oxford, UK

Received 4 February 2013; Accepted 7 March 2013

Academic Editors: Y. Hayabuchi and T. Ishimitsu

Copyright © 2013 Gemina Doolub and Erica Dall'Armellina. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Aims. Previous studies have suggested that intravenous administration of adenosine improves myocardial reperfusion and reduces infarct size in ST-elevation myocardial infarction (STEMI) patients. Intracoronary administration of adenosine has shown conflicting results. Methods. In this retrospective, single-centre, blinded clinical study, we assessed whether selective intracoronary administration of adenosine distal to the occlusion site immediately before initial balloon inflation reduces microvascular obstruction (MVO) as assessed with cardiac magnetic resonance imaging (MRI). Using contrast-enhanced sequences, microvascular obstruction (MVO) was calculated. We found 81 patients presenting with STEMI within 12 h from symptom onset who were eligible for the study. In 80/81 (100%) patients receiving the study drug, MRI was performed on Day 1 after primary angioplasty. Results. The prevalence of MVO was reduced in the patients treated with intracoronary adenosine, (45%) compared to 85% of patients who were administered intravenous adenosine ( ). We found that the size of MVO in patients receiving intracoronary adenosine was significantly reduced compared to 0.91 g in the intravenous-treated group ( ). There was no statistically significant difference in TIMI flow and clinical outcomes after primary PCI. Conclusion. We found significant evidence that selective high-dose intracoronary administration of adenosine distal to the occlusion site of the culprit lesion in STEMI patients results in a decrease in microvascular obstruction.