Abstract: Objective: To evaluate the clinical efficacy of high dose adenosine through percutaneous coronary intervention in the treatment of the acute ST segment elevation myocardial infarction. Methods: Eighty-two patients with acute ST segment elevation myocardial infarction were randomly divided into the study group and control group(42 cases each group). All patients were treated with percutaneous coronary intervention(PCI). The study group and control group were treated with 600 μg of adenosine combined with 10 mL of saline and 300 μg of adenosine combined with 10 mL of saline for 1 min, respectively, then two groups were additionally treated with stenting. Coronary flow of infarction related artery(IRA) was assessed after treatment. The serum levels of creatine kinase, isoenzyme of creatine kinase and cardiac troponin I, drop rate of ST segment elevation and left ventricular ejection fraction between two groups were compared after operation. Results: The biochemical and ECG indexes in study group were significantly better than those in control group after treatment(P<0.05 to P<0.01). The difference of TIMI rating between two groups before operation and after 30 min of operation was not statistically significant(P>0.05). The TIMI rating in study group at the end of operation was better than that in control group(P<0.05). The differences of the incidence of postoperative adverse reactions and serious cardiovascular events after 30 days of operation between two groups were not statistically significant(P>0.05). Conclusions: The treatment of the acute ST segment elevation myocardial infarction with the high dose of adenosine through percutaneous coronary intervention is safe and effective, which has certain application value.