Details

Autor(en) / Beteiligte

• Hahn, Joo-Yong
• Song, Young Bin
• Kim, Eun Kyoung
• Yu, Cheol Woong
• Bae, Jang-Whan
• Chung, Woo-Young
• Choi, Seung-Hyuk
• Choi, Jin-Ho
• Bae, Jang-Ho
• An, Kyung Joo
• Park, Jong-Seon
• Oh, Ju Hyeon
• Kim, Sang-Wook
• Hwang, Jin-Yong
• Ryu, Jae Kean
• Park, Hun Sik
• Lim, Do-Sun
• Gwon, Hyeon-Cheol

Titel

Ischemic Postconditioning During Primary Percutaneous Coronary Intervention: The Effects of Postconditioning on Myocardial Reperfusion in Patients With ST-Segment Elevation Myocardial Infarction (POST) Randomized Trial

Ist Teil von

• Circulation (New York, N.Y.), 2013-10, Vol.128 (17), p.1889-1896

Ort / Verlag

Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2013

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND—Ischemic postconditioning has been reported to reduce infarct size in patients with ST-segment–elevation myocardial infarction. However, cardioprotective effects of postconditioning have not been demonstrated in a large-scale trial. METHODS AND RESULTS—We performed a multicenter, prospective, randomized, open-label, blinded end-point trial. A total of 700 patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment–elevation myocardial infarction within 12 hours after symptom onset were randomly assigned to the postconditioning group or to the conventional primary PCI group in a 1:1 ratio. Postconditioning was performed immediately after restoration of coronary flow as followsThe angioplasty balloon was positioned at the culprit lesion and inflated 4 times for 1 minute with low-pressure (<6 atm) inflations, each separated by 1 minute of deflation. The primary end point was complete ST-segment resolution (percentage resolution of ST-segment elevation >70%) measured at 30 minutes after PCI. Complete ST-segment resolution occurred in 40.5% of patients in the postconditioning group and 41.5% of patients in the conventional PCI group (absolute difference, −1.0%; 95% confidence interval, −8.4 to 6.4; P=0.79). The rate of myocardial blush grade of 0 or 1 and the rate of major adverse cardiac events (a composite of death, myocardial infarction, severe heart failure, or stent thrombosis) at 30 days did not differ significantly between the postconditioning group and the conventional PCI group (17.2% versus 22.4% [P=0.20] and 4.3% versus 3.7% [P=0.70], respectively). CONCLUSION—Ischemic postconditioning did not improve myocardial reperfusion in patients with ST-segment–elevation myocardial infarction undergoing primary PCI with current standard practice. CLINICAL TRIAL REGISTRATION—URLhttp://clinicaltrials.gov. Unique identifierNCT00942500.