title: Effect of postconditioning in patients with ST-elevation acute myocardial infarction.
abstract: Postconditioning (PosC), which is a brief period of ischemia performed at the time of reperfusion therapy, reduces the infarct size in animal models. We aim to evaluate the impact of PosC in patients with ST-elevation acute myocardial infarction (STEMI). Between January 2008 and August 2009, 37 STEMI patients received PosC. The control group comprised 42 age- and sex-matched patients diagnosed with STEMI in 2007-2008. In the PosC group, we applied four cycles of 30-s balloon inflation and 30-s balloon deflation within 3 min after thrombectomy, and implanted the stent after PosC. In the control group, we directly implanted the stent after thrombectomy. The number of patients with myocardial blush grade 2 or 3 after the procedure was higher in the PosC group than in the control group (65 vs. 43%, p = 0.04). The ST-segment resolution >50% was greater in the PosC group compared to the control group (81 vs. 57%, p = 0.02). Serial changes of creatine kinase and creatine kinase myocardial fraction after reperfusion were significantly lower in the PosC group than in the control group. In conclusion, PosC is a safe and feasible strategy that might preserve myocardial perfusion and reduce the infarct size in patients with STEMI.
authors.affiliation: Cardiovascular Division, Saitama Citizens Medical Center, 299-1 Shimane, Nishi-ku, Saitama, Saitama, 331-0054, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ugata
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Shinichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D016022:Case-Control Studies; D017023:Coronary Angiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057775:Ischemic Postconditioning; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D061214:Patient Safety; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome