No Cardioprotective Benefit of Ischemic Postconditioning in Patients With ST‐Segment Elevation Myocardial Infarction

Journal of Interventional Cardiology - Tập 26 Số 5 - Trang 482-490 - 2013
Nathan Dwyer1, Yoko Mikami1, Darlene Hilland1, Ahmed Aljizeeri2, Matthias G. Friedrich1, Mouhieddin Traboulsi1, Todd J. Anderson1
1Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
2Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

Tóm tắt

AbstractBackgroundPostconditioning is a potential cardioprotective strategy that has demonstrated conflicting and variable reductions in infarct size in human trials.ObjectivesTo determine whether postconditioning could increase the extent of myocardial salvage in patients with acute ST‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI).MethodsOne hundred two patients (aged 57 ± 11 years; 88% male) were randomly assigned to a postconditioning or standard protocol. Cardiovascular magnetic resonance imaging was performed 3 days after PPCI to measure the volumetric extent of myocardial necrosis and the area at risk.ResultsWith similar time‐to‐reperfusion (170 ± 84 minutes in the postconditioning group vs. 150 ± 70 minutes in the standard group, P = 0.22), the myocardial salvage index was not significantly different between the postconditioned group and the control group, averaging 42 ± 22% vs. 33 ± 21%, respectively (P = 0.08). Furthermore, postconditioning was not associated with a smaller infarct size compared to controls (13 ± 7 g/m2 vs. 15 ± 8 g/m2, respectively, P = 0.18).ConclusionsPostconditioning does not significantly increase myocardial salvage or reduce infarct size in patients with STEMI undergoing PPCI. However, the possibility of a more modest impact of postconditioning cannot be excluded with our sample size. (J Interven Cardiol 2013;26:482‐490)

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Journal of Interventional Cardiology

Tập 26 Số 5

482-490

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