title: Long-term effects of ischemic postconditioning on clinical outcomes: 1-year follow-up of the POST randomized trial.
abstract: BACKGROUND
  In the Effects of Postconditioning on Myocardial Reperfusion in Patients with ST-segment Elevation Myocardial Infarction (POST) trial, ischemic postconditioning failed to improve myocardial reperfusion. However, long-term effects of ischemic postconditioning on clinical outcomes are not known in patients with ST-segment elevation myocardial infarction.
  
  
  METHODS
  A total of 700 patients undergoing primary percutaneous coronary intervention (PCI) were randomly assigned to the postconditioning group or the conventional primary PCI group in a 1:1 ratio. Postconditioning was performed immediately after restoration of coronary flow by balloon occlusion 4 times for 1 minute. Complete follow-up data for major clinical events at 1 year were available in 695 patients (99.3%), and analyses were done by the intention to treat principle. The primary outcome was a composite of death, myocardial infarction, severe heart failure, or stent thrombosis at 1 year.
  
  
  RESULTS
  At 1 year, a composite of death, myocardial infarction, severe heart failure, or stent thrombosis occurred in 21 patients (6.1%) in the postconditioning group and 16 patients (4.6%) in the conventional PCI group (hazard ratio [HR] 1.32, 95% CI 0.69-2.53, P = .40). The risk of death (4.9% vs 3.7%, HR 1.32, 95% CI 0.64-2.71, P = .46), heart failure (2.6% vs 2.3%, HR 1.13, 95% CI 0.44-2.94, P = .80), and stent thrombosis (2.3% vs 1.7%, HR 1.34, 95% CI 0.46-3.85, P = .59) did not differ significantly between the 2 groups.
  
  
  CONCLUSIONS
  Ischemic postconditioning does not seem to improve the 1-year clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary PCI.
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: jyhahn@skku.edu.
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.affiliation: Korea University Anam Hospital, Seoul, Korea.
authors.forename: Cheol Woong
authors.initials: CW
authors.lastname: Yu
authors.affiliation: Kyungpook National University Hospital, Daegu, Korea. Electronic address: hspark@knu.ac.kr.
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun Kyoung
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Sejong General Hospital, Bucheon, Korea.
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Jang-Whan
authors.initials: JW
authors.lastname: Bae
authors.affiliation: Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Woo-Young
authors.initials: WY
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Konyang University Hospital, Daejon, Korea.
authors.forename: Jang-Ho
authors.initials: JH
authors.lastname: Bae
authors.affiliation: KEPCO Medical Center, Seoul, Korea.
authors.forename: Kyung Joo
authors.initials: KJ
authors.lastname: An
authors.affiliation: Yeungnam University Hospital, Daegu, Korea.
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.affiliation: Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: Ju Hyeon
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Jin-Yong
authors.initials: JY
authors.lastname: Hwang
authors.affiliation: Daegu Catholic University Medical Center, Daegu, Korea.
authors.forename: Jae Kean
authors.initials: JK
authors.lastname: Ryu
authors.affiliation: Korea University Anam Hospital, Seoul, Korea.
authors.forename: Do-Sun
authors.initials: DS
authors.lastname: Lim
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
mesh_terms: D000368:Aged; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D057775:Ischemic Postconditioning; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D012306:Risk; D015607:Stents; D016896:Treatment Outcome