title: Ischemic Postconditioning Before Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction Reduces Contrast-induced Nephropathy and Improves Long-term Prognosis.
abstract: OBJECTIVE
  Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is one of the major adverse outcomes affecting the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI). Ischemic postconditioning prior to PCI (pre-PCI) in patients with STEMI is hypothesized to be protective against CIN after PCI.
  
  
  METHODS
  A total of 251 patients with STEMI were randomized into two groups: ischemic postconditioning group (n = 123, age, 61.1 ± 12.5 years) who underwent ischemic postconditioning prior to PCI; control group (n = 128; age, 64.1 ± 12.1 years) who underwent only PCI. Ischemic postconditioning was administered by three cycles of deflation and inflation of the balloon (1-min ischemia and 1-min reperfusion) starting 1 min after infarct-related artery (IRA) opening. Diagnostic criterion for CIN was: increase in serum creatinine level by ≥0.5 mg/dL or by ≥25% increase from preoperative level within 48 h of surgery. All patients were followed for 1 year for incidence of major cardiovascular events (MACE).
  
  
  RESULTS
  The incidence of postoperative CIN in the ischemic postconditioning group was 5.69% as compared to 14.06% in the control group (p <0.05). At one year, the MACE incidence in the ischemic postconditioning group was 7.32% as compared to 15.63% in the control group (p <0.05).
  
  
  CONCLUSIONS
  Pre-PCI ischemic postconditioning in STEMI patients significantly reduces the post-PCI incidence of CIN and improves long-term prognosis.
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Yun-Yun
authors.initials: YY
authors.lastname: Wang
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China. Electronic address: litong3zx@sina.com.
authors.forename: Tong
authors.initials: T
authors.lastname: Li
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Ying-Wu
authors.initials: YW
authors.lastname: Liu
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Hu
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Wen-Qing
authors.initials: WQ
authors.lastname: Gao
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Wu
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Wen-Jin
authors.initials: WJ
authors.lastname: Peng
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Guang-Dong
authors.initials: GD
authors.lastname: Yu
authors.affiliation: Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.
authors.forename: Bo-Jiang
authors.initials: BJ
authors.lastname: Liu
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D057775:Ischemic Postconditioning; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: Acute myocardial infarction; Contrast-induced nephropathy; Ischemic postconditioning; Long term prognosis; Percutaneous coronary intervention