Adenosine in Interventional Cardiology: Physiopathologic and Pharmacologic Effects in Coronary Artery Disease

• Published in: International journal of molecular sciences 2024-06, Vol.25 (11), p.5852
• Main Authors: Marchi, Enrico, Muraca, Iacopo, Berteotti, Martina, Gori, Anna Maria, Valenti, Renato, Marcucci, Rossella
• Format: Article
• Language: English
• Subjects: Adenosine; Adenosine - metabolism; Adenosine diphosphate; Adenosine Monophosphate - analogs & derivatives; Adenosine Monophosphate - metabolism; Adenosine Monophosphate - therapeutic use; Adenosine triphosphate; Aggregation; Animals; antiplatelet therapy; Blood platelets; Cardiovascular disease; Cardiovascular system; Care and treatment; Cholesterol; coronary artery disease; Coronary Artery Disease - drug therapy; Coronary Artery Disease - metabolism; Coronary heart disease; Coronary vessels; Diseases; Dyspnea; Enzymes; Health aspects; Heart attacks; Heart beat; Heart rate; Homocysteine; Humans; Ischemia; Kinases; Metabolism; no-reflow phenomenon; Physiological aspects; Platelet Aggregation Inhibitors - pharmacology; Platelet Aggregation Inhibitors - therapeutic use; Review; Smooth muscle; stress testing; Tachycardia; Vein & artery diseases
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms25115852

This review article focuses on the role of adenosine in coronary artery disease (CAD) diagnosis and treatment. Adenosine, an endogenous purine nucleoside, plays crucial roles in cardiovascular physiology and pathology. Its release and effects, mediated by specific receptors, influence vasomotor function, blood pressure regulation, heart rate, and platelet activity. Adenosine therapeutic effects include treatment of the no-reflow phenomenon and paroxysmal supraventricular tachycardia. The production of adenosine involves complex cellular pathways, with extracellular and intracellular synthesis mechanisms. Adenosine's rapid metabolism underscores its short half-life and physiological turnover. Furthermore, adenosine's involvement in side effects of antiplatelet therapy, particularly ticagrelor and cangrelor, highlights its clinical significance. Moreover, adenosine serves as a valuable tool in CAD diagnosis, aiding stress testing modalities and guiding intracoronary physiological assessments. Its use in assessing epicardial stenosis and microvascular dysfunction is pivotal for treatment decisions. Overall, understanding adenosine's mechanisms and clinical implications is essential for optimizing CAD management strategies, encompassing both therapeutic interventions and diagnostic approaches.