Effects of adenosine on oxidative stress and inflammation in patients with coronary heart disease underlying percutaneous coronary intervention

Objective To determine whether rapid intracoronary adenosine administration attenuates percutaneous coronary intervention (PCI)–induced systemic inflammation and oxidative stress in patients with coronary artery disease. Methods This prospective, randomized controlled trial enrolled patients undergoing coronary angiography (coronary angiography group) or PCI. Patients undergoing PCI were assigned to receive intracoronary adenosine (PCI + adenosine group) or placebo (PCI group). Blood levels of inflammatory markers (e.g. cytokines), anti-inflammatory mediators, and oxidative stress indicators (superoxide dismutase and malondialdehyde) were measured before and 24 h after the procedure. Results Compared to the coronary angiography group, patients undergoing PCI who received placebo exhibited concurrent elevations in inflammatory and anti-inflammatory markers at 24 h. Intracoronary adenosine significantly suppressed the rise in the levels of inflammatory markers (e.g. interleukin-6 reduced by 35% vs. placebo) and enhanced anti-inflammatory responses (e.g. interleukin-10 increased by 40% vs. placebo). Following PCI, oxidative stress was evident in placebo-treated patients, as reflected by decreased superoxide dismutase activity (15% reduction) and increased malondialdehyde levels (30% elevation). Adenosine restored superoxide dismutase activity to near-baseline levels and reduced malondialdehyde elevation by 85% compared to placebo. Conclusions Intracoronary adenosine mitigates PCI-associated systemic inflammation and oxidative stress by rebalancing inflammatory pathways and preserving redox homeostasis. These findings highlight its potential as a therapeutic adjunct for improving clinical outcomes following PCI and warrant further validation in large-scale trials. Clinical Trial Registration : Chinese Clinical Trial Registry (ChiCTR); identifier: ChiCTR1800019349.