Adenosine + Thrombolysis Cuts Infarcts

Medco Research reported data at the American Heart Association meetingon the combination of adenosine with thrombolysis in patients suffering a myocardial infarction, which suggest that it reduces infarct size compared to thrombolysis alone.

The 236-patient study, called AMISTAD (Acute Myocardial Infarction Study of Adenosine), compared the effects of administering adenosine (70mcg/kg/min intravenously for three hours) to saline control on top of thrombolysis with either streptokinase or tissue plasminogen activator. Patients were stratified at the outset of the study according to the location of the infarct, in order to see if adenosine had any effects on a particular type. The primary endpoint was size of infarct, measured as a percentage of the chamber of the heart affected.

Patients with anterior MI who received adenosine had a median infarct size of 15%, compared to 45.5% for placebo (a significant improvement). There was no difference between the treatments in patients with non-anterior MI (11.5% in both groups). Patients with anterior infarcts are most at risk of a poor outcome.