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Effect of postcondi...
Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction
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- Sorensson, P. (author)
- Karolinska Institutet
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- Saleh, N. (author)
- Karolinska Institutet
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Bouvier, F. (author)
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- Bohm, F. (author)
- Karolinska Institutet
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- Settergren, M. (author)
- Karolinska Institutet
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- Caidahl, Kenneth, 1949 (author)
- Karolinska Institutet,Gothenburg University,Göteborgs universitet,Extern,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,External,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Tornvall, P. (author)
- Karolinska Institutet
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- Arheden, Håkan (author)
- Lund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Ryden, L. (author)
- Karolinska Institutet
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- Pernow, J. (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2010-10-18
- 2010
- English.
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In: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 96:21, s. 1710-5
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Abstract
Subject headings
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- BACKGROUND: Small studies suggest that postconditioning reperfusion interrupted by brief repetitive cycles of reocclusions, may protect the myocardium in the clinical setting. OBJECTIVE: To test the hypothesis that postconditioning limits infarct size in relation to the area at risk in patients with ST elevation myocardial infarction (STEMI). METHODS: 76 patients (aged 37-87 years) eligible for primary percutaneous coronary intervention due to STEMI were randomised to standard percutaneous coronary intervention (n = 38) or postconditioning, consisting of four cycles of 60 s reperfusion and 60 s of reocclusion before permanent reperfusion (n = 38). RESULTS: The area at risk was determined from angiographic abnormally contracting segments. Infarct size was quantified from delayed enhancement MRI on days 6-9. Infarct size, expressed in relation to the area at risk, did not differ between the control group (44%; 30, 56) (median and quartiles) and the post-conditioned group (47%; 23, 63). The slope of the regression lines relating infarct size to the area at risk differed between the two groups. Infarct size was significantly (p = 0.001) reduced by postconditioning in patients with large areas at risk. The area under the curve and peak troponin T release and CKMB during 48 h did not differ between patients in the control and postconditioning groups. CONCLUSIONS: This prospective, randomised trial suggests that postconditioning does not reduce infarct size in patients with STEMI in the overall study group. The data indicate that postconditioning may be of value in patients with large areas at risk. Clinical trial registration information Karolinska Clinical Trial Registration (http://www.kctr.se). Unique identifier: CT20080014.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Adult
- Aged
- Aged
- 80 and over
- Angioplasty
- Balloon
- Coronary/adverse effects/*methods
- Biomarkers/blood
- Creatine Kinase
- MB Form/blood
- Electrocardiography
- Female
- Humans
- Ischemic Preconditioning
- Myocardial/*methods
- Magnetic Resonance Imaging/methods
- Male
- Middle Aged
- Myocardial Infarction/pathology/physiopathology/*therapy
- Myocardial Reperfusion Injury/etiology/*prevention & control
- Prospective Studies
- Stroke Volume
- Troponin T/blood
Publication and Content Type
- ref (subject category)
- art (subject category)
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Heart
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- By the author/editor
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Sorensson, P.
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Saleh, N.
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Bouvier, F.
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Bohm, F.
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Settergren, M.
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Caidahl, Kenneth ...
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show more...
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Tornvall, P.
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Arheden, Håkan
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Ryden, L.
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Pernow, J.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Heart
- By the university
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University of Gothenburg
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Lund University
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Karolinska Institutet