Design and methodologies of the POSTconditioning during coronary angioplasty in acute myocardial infarction (POST-AMI) trial.
BACKGROUND
Reperfusion remains the definitive treatment for acute myocardial infarction (AMI), but restoring blood flow carries the potential to exacerbate the ischemia-related injury. Postconditioning might modify reperfusion-induced adverse events.


METHODS
The POSTconditioning during Coronary Angioplasty in Acute Myocardial Infarction (POST-AMI) trial is a single-center, prospective, randomized study, with a planned inclusion of 78 patients with ST-elevation AMI. Patients will be randomly assigned to the postconditioning arm [primary angioplasty (PA) and stenting followed by brief episodes of ischemia-reperfusion early after recanalization] or non-postconditioning arm. All patients will be treated medically according to current international guidelines, including glycoprotein IIb/IIIa inhibitors before PA. The primary end point is to evaluate whether postconditioning, compared to plain PA, reduces infarct size estimated by cardiac magnetic resonance (CMR) at 30 +/- 10 days after the AMI. Secondary end points are microvascular obstruction observed at CMR, ST-segment resolution, angiographic myocardial blush grade <2, non-sustained/sustained ventricular tachycardia in the 48 h following PA, left ventricular remodeling and function at follow-up CMR, and the reduction of major adverse cardiac events at 30 days and 6 months.


CONCLUSIONS
The POST-AMI trial will evaluate the usefulness of postconditioning in limiting infarct size during the early and late phases after AMI.
Tarantini
Giuseppe
G
Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. giuseppe.tarantini.1@unipd.it
Favaretto
Enrico
E
Napodano
Massimo
M
Perazzolo Marra
Martina
M
Cacciavillani
Luisa
L
Babuin
Luciano
L
Giovagnoni
Andrea
A
Renda
Pietro
P
De Biasio
Valeria
V
Plebani
Mario
M
Mion
Monica
M
Zaninotto
Martina
M
Mistrorigo
Flavio
F
Panfili
Marco
M
Isabella
Giambattista
G
Bilato
Claudio
C
Iliceto
Sabino
S
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D017202:Myocardial Ischemia / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012107:Research Design