{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:19:04Z","timestamp":1792081144728,"version":"4.4.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Adenosine is used to treat no\u2010reflow in the infarct\u2010related artery (IRA) during ST\u2010segment\u2013elevation myocardial infarction intervention. However, the physiological effect of adenosine in the IRA is variable. Coronary steal\u2014a reduction of blood flow to the distal coronary bed\u2014can occur in response to adenosine and this is facilitated by collaterals. We investigated the effects of adenosine on coronary flow reserve (CFR) in patients presenting with ST\u2010segment\u2013elevation myocardial infarction to better understand the physiological mechanism underpinning the variable response to adenosine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Pressure\u2010wire assessment of the IRA after percutaneous coronary intervention was performed in 93 patients presenting with ST\u2010segment\u2013elevation myocardial infarction to calculate index of microvascular resistance, CFR, and collateral flow index by pressure. Modified collateral Rentrop grade to the IRA was recorded, as was microvascular obstruction by cardiac magnetic resonance imaging. Coronary steal (CFR &lt;0.9), no change in flow (CFR=0.9\u20131.1), and hyperemic flow (CFR &gt;1.1) after adenosine occurred in 19 (20%), 15 (16%), and 59 (63%) patients, respectively. Patients with coronary steal had higher modified Rentrop score to the IRA (1 [0, 1.75] versus 0 [0, 1],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and a higher collateral flow index by pressure (0.25\u00b10.10 versus 0.15\u00b10.10,\n              <jats:italic>P<\/jats:italic>\n              =0.004) than the hyperemic group. The coronary steal group also had significantly higher index of microvascular resistance (61.68 [28.13, 87.04] versus 23.93 [14.67, 37.00],\n              <jats:italic>P<\/jats:italic>\n              =0.006) and had more disease (stenosis &gt;50%) in the donor arteries (52.63% versus 22.03%,\n              <jats:italic>P<\/jats:italic>\n              =0.02) than the hyperemic group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Adenosine\u2010induced coronary steal may be responsible for a reduction in coronary flow reserve in a proportion of patients presenting with ST\u2010segment\u2013elevation myocardial infarction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03145194. URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.isrctn.com\">https:\/\/www.isrctn.com<\/jats:ext-link>\n              ; Unique identifier: ISRCTN3176727.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019899","type":"journal-article","created":{"date-parts":[[2021,6,30]],"date-time":"2021-06-30T09:03:24Z","timestamp":1625043804000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Adenosine\u2010Induced Coronary Steal Is Observed in Patients Presenting With ST\u2010Segment\u2013Elevation Myocardial Infarction"],"prefix":"10.1161","volume":"10","author":[{"given":"Muhammad","family":"Aetesam\u2010ur\u2010Rahman","sequence":"first","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"},{"name":"Division of Cardiovascular Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4531-6052","authenticated-orcid":false,"given":"Adam J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Cardiology Monash University Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Jaworski","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Geelong Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8020-5433","authenticated-orcid":false,"given":"Joel P.","family":"Giblett","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"},{"name":"Division of Cardiovascular Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-5255","authenticated-orcid":false,"given":"Tian X.","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"},{"name":"Division of Cardiovascular Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Braganza","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby S. K.","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Papworth Hospital Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-1825","authenticated-orcid":false,"given":"Martin R.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick E. 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