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Ottervanger JP, Gregor P, Widimsky P, et al. Cardioprotective effects of adenosine transport inhibition during reversible ischaemia in patients with coronary artery disease. Int J Cardiovasc Intervent. 1999;2(3):181-186doi: 10.1080/acc.2.3.181.186.
Ottervanger, J. P., Gregor, P., Widimsky, P., Zijlstra, F., Kluiver, E. P., Hof, A. W., & Suryapranata, H. (1999). Cardioprotective effects of adenosine transport inhibition during reversible ischaemia in patients with coronary artery disease. International journal of cardiovascular interventions, 2(3), 181-186. https://doi.org/10.1080/acc.2.3.181.186
Ottervanger, Jan Paul, et al. "Cardioprotective effects of adenosine transport inhibition during reversible ischaemia in patients with coronary artery disease." International journal of cardiovascular interventions vol. 2,3 (1999): 181-186. doi: https://doi.org/10.1080/acc.2.3.181.186
Ottervanger JP, Gregor P, Widimsky P, Zijlstra F, Kluiver EP, Hof AW, Suryapranata H. Cardioprotective effects of adenosine transport inhibition during reversible ischaemia in patients with coronary artery disease. Int J Cardiovasc Intervent. 1999;2(3):181-186. doi: 10.1080/acc.2.3.181.186. PMID: 12623587.
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Int J Cardiovasc Intervent. 1999;2(3):181-186. doi: 10.1080/acc.2.3.181.186.

Cardioprotective effects of adenosine transport inhibition during reversible ischaemia in patients with coronary artery disease.

International journal of cardiovascular interventions

Jan Paul Ottervanger, Pavel Gregor, Petr Widimsky, Felix Zijlstra, Ed P de Kluiver, Arnoud W van't Hof, Harry Suryapranata

Affiliations

  1. Department of Cardiology, Hospital "De Weezenlanden", Zwolle, The Netherlands.

PMID: 12623587 DOI: 10.1080/acc.2.3.181.186

Abstract

BACKGROUND: Adenosine plays a major role in protecting ischaemic myocardium and may potentiate ischaemic preconditioning. Nucleosine transport inhibition may enhance these favourable effects. DESIGN: Randomized, double blind, placebo controlled study, to investigate the haemodynamic and cardioprotective effects of nucleoside transport inhibition during ischaemia in patients with coronary artery disease. PATIENTS AND METHODS: Elective left anterior descending (LAD) coronary angioplasty was used to produce reversible ischaemia in 24 patients with stable angina and a single LAD lesion. They were randomized to receive either the nucleoside transport inhibitor draflazine or placebo. The study medication was infused between the 2nd and 3rd balloon inflation. The primary endpoint was ischaemia-induced wall motion abnormalities as measured by left septal echo amplitude, which was plotted against time to produce an area under the curve. RESULTS: No differences were observed in the systemic haemodynamics or the myocardial collateral circulation of the two groups. The ischaemia-induced regional wall motion abnormalities improved significantly after draflazine, while no difference was observed in the placebo group. This improvement was even more pronounced in patients with low caffeine levels compared with those with high caffeine levels. CONCLUSIONS: Draflazine, in the dose and route used, is associated with a significant improvement in regional myocardial function of the ischaemic area, without affecting systemic or collateral circulation, when compared with placebo. This implies that draflazine has a cardio-protective effect in ischaemic myocardium. High caffeine blood levels reduce these effects.

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