{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:17:04Z","timestamp":1784895424663,"version":"3.55.0"},"reference-count":22,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The no-reflow phenomenon is associated with a considerable reduction in myocardial salvage in patients with ST elevation myocardial infarction (STEMI) treated by primary percutaneous intervention (PCI). There has been no head-to-head comparison of intra-coronary epinephrine to adenosine in the management of no-reflow phenomenon.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>Evaluate the short- and long-term efficacy and safety of using intracoronary epinephrine versus adenosine for management of the catastrophic no-reflow phenomenon that may occur during primary PCI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN:<\/jats:title>\n            <jats:p>Retrospective cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SETTING:<\/jats:title>\n            <jats:p>Single center in Egypt.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>PATIENTS AND METHODS:<\/jats:title>\n            <jats:p>The study included STEMI patients who developed refractory no-reflow phenomenon during primary PCI after failure of conventional treatments and received either intracoronary epinephrine or adenosine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MAIN OUTCOME MEASURES:<\/jats:title>\n            <jats:p>No-reflow management measured through improvement of thrombolysis in myocardial infarction grade (TIMI flow), myocardial blush grade, TIMI frame count and major adverse cardiovascular events (MACE) at 1-year follow up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SAMPLE SIZE:<\/jats:title>\n            <jats:p>156 patients with refractory no-reflow phenomenon during primary PCI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Successful reperfusion was achieved in 74 of 81 (91.4%) of patients who received epinephrine and in 65 of 75 (86.7%) who received adenosine (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;.05). Fifty-six of 81 patients (69.1%) achieved TIMI III flow after epinephrine administration versus 39 of 75 patients (52.7%) in the adenosine group (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =.04). The incidence of heart failure after 1 year of follow up was lower in the epinephrine group compared to the adenosine group (6.3% vs. 19.2%,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;.017). MACE after 1 year of follow up was lower in patients who received epinephrine compared to those who received adenosine (11.3 % Vs. 26.7 %,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;.01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>During primary PCI, intracoronary epinephrine is as effective as adenosine in successful management of refractory no-reflow phenomenon with a more favorable long-term prognosis compared to adenosine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LIMITATIONS:<\/jats:title>\n            <jats:p>Retrospective design.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONFLICT OF INTEREST:<\/jats:title>\n            <jats:p>None.<\/jats:p>\n          <\/jats:sec>","DOI":"10.5144\/0256-4947.2022.75","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T11:59:24Z","timestamp":1649159964000},"page":"75-82","source":"Crossref","is-referenced-by-count":17,"title":["Intracoronary epinephrine versus adenosine in the management of refractory no-reflow phenomenon: a single-center retrospective cohort study"],"prefix":"10.5144","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8400-3492","authenticated-orcid":true,"given":"Ahmed","family":"Darwish","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdel-Fattah","family":"Frere","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdy","family":"Abdelsamie","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed El","family":"Awady","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Gouda","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3134","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_3_1_3_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/978-981-13-1114-7_17","volume-title":"Primary Angioplasty: A Practical Guide","author":"Adjedj J","year":"2018","unstructured":"Adjedj J, Muller O, Eeckhout E. 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