title: ST-Segment resolution and clinical outcome with ischemic postconditioning and comparison to magnetic resonance.
abstract: BACKGROUND
  Ischemic postconditioning (IPost) during primary percutaneous coronary intervention (PPCI) is suggested to reduce myocardial damage. However, the association with ST-segment resolution (STR) and clinical outcome is not determined. The primary aim of this study was to evaluate the association of IPost with STR and clinical outcome. Secondly, we sought to determine the relationship between STR and cardiac magnetic resonance (CMR) parameters in these patients.
  
  
  METHODS
  One hundred eighteen patients referred for PPCI were randomly assigned to either conventional PPCI or PPCI with IPost. In a single electrocardiographic lead, STR was determined. Treatment modalities were compared as regards STR, ST-segment elevation, and the number of patients achieving complete-STR (≥70%), incomplete-STR (30%-70%), and no-STR (<30%). Patients were evaluated for clinical outcome after 15 months. Furthermore, patients with and without complete-STR were compared as regards CMR parameters.
  
  
  RESULTS
  There was a tendency toward a better outcome with IPost for the number of patients achieving complete-STR (55% vs 63%; P=.09), ST-segment elevation (1.41 vs 1.12 mm; P=.07), and New York Heart Association class (P=.06). No difference in other cardiac events was observed. Furthermore, data determine that patients with complete-STR have smaller infarct size (12.9% vs 21.1%; P<.01) and a better ejection fraction (55.7% vs 47.7%; P<.01).
  
  
  CONCLUSIONS
  Patients treated with IPost are suggested to have improved STR and New York Heart Association classification. Infarct size and the functional CMR parameters were better in the patients with complete-STR; as to this, single-lead STR remains an important predictor for successful treatment in patients treated with IPost.
authors.affiliation: Department of Cardiology, Rigshospitalet, and The Danish National Foundation Research Centre for Heart Arrhythmia, University of Copenhagen, Copenhagen, Denmark. jacoblonborg@gmail.com
authors.forename: Jacob
authors.initials: J
authors.lastname: Lønborg
authors.forename: Lene
authors.initials: L
authors.lastname: Holmvang
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.forename: Niels
authors.initials: N
authors.lastname: Vejlstrup
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
authors.forename: Kari
authors.initials: K
authors.lastname: Saunamäki
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen
authors.forename: Marek
authors.initials: M
authors.lastname: Treiman
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
mesh_terms: D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D009206:Myocardium / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome