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Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance.
- Source :
-
Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2010 Feb 01; Vol. 3 (1), pp. 34-41. Date of Electronic Publication: 2010 Jan 26. - Publication Year :
- 2010
-
Abstract
- Background: Postconditioning has been suggested to reduce myocardial damage during primary percutaneous coronary intervention (PPCI) in patients with ST-segment-elevation myocardial infarction. However, because clinical experience is limited, we examined the cardioprotective effects of postconditioning, using cardiac MRI in patients treated with PPCI.<br />Methods and Results: One hundred eighteen patients with ST-segment-elevation myocardial infarction referred for PPCI were randomly assigned to have either conventional PPCI or PPCI with postconditioning. Postconditioning was performed immediately after obtained reperfusion with 4 balloon occlusions, each lasting 30 seconds, followed by 30 seconds of reperfusion. The primary end point was myocardial salvage after 3 months as judged by delayed enhancement cardiac MRI. We found a 19% relative reduction of infarct size in the postconditioning group (51+/-16% of total area at risk versus 63+/-17%, P<0.01), corresponding to a 31% increase in salvage ratio. The number of patients developing heart failure was significantly fewer in the postconditioning group (27% versus 46%, P=0.048). No significant evidence of interaction between the impact of postconditioning and the location of the culprit lesion or size of the myocardium at risk was detected (P=0.21 and P=0.71).<br />Conclusions: Mechanical postconditioning reduces infarct size in patients with ST-segment-elevation myocardial infarction treated with PPCI. The impact of mechanical postconditioning seems to be independent of the size of myocardium at risk.<br />Clinical Trial Registration- Url: http://www.clinicaltrials.gov. Unique Identifier: NCT00507156.
- Subjects :
- Aspirin administration & dosage
Aspirin adverse effects
Cardiotonic Agents administration & dosage
Cardiotonic Agents adverse effects
Chemotherapy, Adjuvant
Clopidogrel
Disease Progression
Electrocardiography
Female
Heart Function Tests
Heparin administration & dosage
Heparin adverse effects
Humans
Magnetic Resonance Angiography
Male
Middle Aged
Myocardial Infarction mortality
Myocardial Infarction physiopathology
Prospective Studies
Survival Analysis
Ticlopidine administration & dosage
Ticlopidine adverse effects
Ticlopidine analogs & derivatives
Angioplasty, Balloon, Coronary
Myocardial Infarction therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7632
- Volume :
- 3
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Circulation. Cardiovascular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 20118154
- Full Text :
- https://doi.org/10.1161/CIRCINTERVENTIONS.109.905521