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A Randomized, Double-Blinded, Placebo-Controlled Multicenter Trial of Adenosine as an Adjunct to Reperfusion in the Treatment of Acute Myocardial Infarction (AMISTAD-II)

Allan M. Ross, MD, FACC^_*, Raymond J. Gibbons, MD, FACC, Gregg W. Stone, MD, FACC, Robert A. Kloner, MD, PhD, FACC, R. Wayne Alexander, MD, PhD, FACC^||,_* for the AMISTAD-II Investigators

^_* Department of Medicine, George Washington University, Washington, DC
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota
Columbia University Medical Center and The Cardiovascular Research Foundation, New York, New York
Keck School of Medicine, Division of Cardiovascular Medicine, University of Southern California and the Heart Institute of Good Samaritan Hospital, Los Angeles, California
^|| Department of Medicine, Emory University School of Medicine, Atlanta, Georgia

View larger version (17K): [in a new window]   Figure 1 Infarct size measured as a percent of the left ventricle (LV) by technetium-99m single-photon emission computed tomographic imaging in the 243 patients in the infarct size substudy with images suitable for quantitation. The 25th percentile, median, and 75th percentiles are shown for the placebo group, the pooled adenosine group, the 50-µg/kg/min adenosine group, and the 70-µg/kg/min adenosine group. Only the higher adenosine dose group showed a significant reduction in median infarct size relative to placebo (p = 0.023)

View larger version (12K): [in a new window]   Figure 2 Infarct size measured as a percent of the left ventricle (LV) by technetium-99m single-photon emission computed tomographic sestamibi imaging in the 28 patients in the infarct size substudy who suffered a primary end point (death, in-hospital congestive heart failure [CHF], or re-hospitalization for CHF), compared with the 215 patients who did not have an end point. The 25th percentile, median, and 75th percentiles are shown for each group. The group with a primary end point had larger infarcts than did those without (p < 0.001).