Cardioprotective effects of ischemic Postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance

Jacob Lønborg*, Henning Kelbæk, Niels Vejlstrup, Erik Jørgensen, Steffen Helqvist, Kari Saunamäki, Peter Clemmensen, Lene Holmvang, Marek Treiman, Jan S. Jensen, Thomas Engstrøm

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    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. 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). 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. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique Identifier: NCT00507156.

    OriginalsprogEngelsk
    Sider (fra-til)34-41
    Antal sider8
    TidsskriftCirculation: Cardiovascular Interventions
    Vol/bind3
    Udgave nummer1
    DOI
    StatusUdgivet - 1 feb. 2010

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