title: Ischemic Postconditioning After Routine Thrombus Aspiration During Primary Percutaneous Coronary Intervention: Rationale and Design of the POstconditioning Rotterdam Trial.
abstract: BACKGROUND
  Whether ischemic postconditioning (IPOC) immediately after routine thrombus aspiration (TA) reduces infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been established.
  
  
  METHODS
  The POstconditioning Rotterdam Trial (PORT) is a dual-center, prospective, open-label, randomized trial with blinded endpoint evaluation enrolling 72 subjects with first-time STEMI, and an occluded infarct-related artery (IRA) without collaterals undergoing PPCI. Subjects are randomized 1:1 to a strategy of IPOC immediately after TA followed by stenting of the IRA or to conventional percutaneous coronary intervention (PCI), including TA followed by stenting of the IRA (controls). Cardiac magnetic resonance imaging (MRI) is performed at 3-5 days after STEMI and at 3 months. The primary endpoint is IS at 3 months measured by delayed enhancement MRI. Other secondary endpoints include MRI-derived microvascular obstruction (MVO), left ventricular ejection fraction, myocardial salvage index, enzymatic IS, ST-segment resolution, myocardial blush grade, microcirculatory resistance, inflammation markers, and clinical events through 3-month follow-up.
  
  
  CONCLUSIONS
  PORT is testing the hypothesis that adding IPOC (against lethal reperfusion injury) to TA (against distal embolization and MVO) is cardioprotective and reduces ultimate IS in STEMI patients undergoing PPCI (Dutch Trial Register identifier: NTR4040). © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands.|Interuniversity Cardiology Institute of the Netherlands, ICIN-KNAW, Utrecht, the Netherlands.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Yetgin
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Matthijs
authors.initials: M
authors.lastname: van Kranenburg
authors.affiliation: Department of Cardiology, UMC St. Radboud, Nijmegen, the Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Ten Cate
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands.|Interuniversity Cardiology Institute of the Netherlands, ICIN-KNAW, Utrecht, the Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Duncker
authors.affiliation: Department of Cardiology, UMC St. Radboud, Nijmegen, the Netherlands.
authors.forename: Menko-Jan
authors.initials: MJ
authors.lastname: de Boer
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands.|Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Robert-Jan M
authors.initials: RM
authors.lastname: van Geuns
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands.|Interuniversity Cardiology Institute of the Netherlands, ICIN-KNAW, Utrecht, the Netherlands.
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands. o.manintveld@erasmusmc.nl.
authors.forename: Olivier C
authors.initials: OC
authors.lastname: Manintveld
mesh_terms: D021721:Balloon Occlusion / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002985:Clinical Protocols; D003326:Coronary Circulation; D006801:Humans; D057775:Ischemic Postconditioning / Q000009:adverse effects / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009426:Netherlands; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation; D011446:Prospective Studies; D012107:Research Design; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015607:Stents; D017131:Thrombectomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: ST-segment elevation myocardial infarction; postconditioning; primary percutaneous coronary intervention; reperfusion injury; thrombus aspiration