title: Design and methodologies of the POSTconditioning during coronary angioplasty in acute myocardial infarction (POST-AMI) trial.
abstract: 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.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. giuseppe.tarantini.1@unipd.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.forename: Enrico
authors.initials: E
authors.lastname: Favaretto
authors.forename: Massimo
authors.initials: M
authors.lastname: Napodano
authors.forename: Martina
authors.initials: M
authors.lastname: Perazzolo Marra
authors.forename: Luisa
authors.initials: L
authors.lastname: Cacciavillani
authors.forename: Luciano
authors.initials: L
authors.lastname: Babuin
authors.forename: Andrea
authors.initials: A
authors.lastname: Giovagnoni
authors.forename: Pietro
authors.initials: P
authors.lastname: Renda
authors.forename: Valeria
authors.initials: V
authors.lastname: De Biasio
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Monica
authors.initials: M
authors.lastname: Mion
authors.forename: Martina
authors.initials: M
authors.lastname: Zaninotto
authors.forename: Flavio
authors.initials: F
authors.lastname: Mistrorigo
authors.forename: Marco
authors.initials: M
authors.lastname: Panfili
authors.forename: Giambattista
authors.initials: G
authors.lastname: Isabella
authors.forename: Claudio
authors.initials: C
authors.lastname: Bilato
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
mesh_terms: 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