PMID- 20956486
OWN - NLM
STAT- MEDLINE
DCOM- 20101108
LR  - 20220408
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 96
IP  - 21
DP  - 2010 Nov
TI  - Effect of postconditioning on infarct size in patients with ST elevation 
      myocardial infarction.
PG  - 1710-5
LID - 10.1136/hrt.2010.199430 [doi]
AB  - 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.
FAU - Sorensson, Peder
AU  - Sorensson P
AD  - Karolinska University Hospital, 171 76 Stockholm, Sweden. 
      peder.sorensson@karolinska.se
FAU - Saleh, Nawzad
AU  - Saleh N
FAU - Bouvier, Frederic
AU  - Bouvier F
FAU - Bohm, Felix
AU  - Bohm F
FAU - Settergren, Magnus
AU  - Settergren M
FAU - Caidahl, Kenneth
AU  - Caidahl K
FAU - Tornvall, Per
AU  - Tornvall P
FAU - Arheden, Hakan
AU  - Arheden H
FAU - Ryden, Lars
AU  - Ryden L
FAU - Pernow, John
AU  - Pernow J
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Biomarkers)
RN  - 0 (Troponin T)
RN  - EC 2.7.3.2 (Creatine Kinase, MB Form)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty, Balloon, Coronary/adverse effects/*methods
MH  - Biomarkers/blood
MH  - Creatine Kinase, MB Form/blood
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Ischemic Preconditioning, Myocardial/*methods
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/pathology/physiopathology/*therapy
MH  - Myocardial Reperfusion Injury/etiology/*prevention & control
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Troponin T/blood
EDAT- 2010/10/20 06:00
MHDA- 2010/11/09 06:00
CRDT- 2010/10/20 06:00
PHST- 2010/10/20 06:00 [entrez]
PHST- 2010/10/20 06:00 [pubmed]
PHST- 2010/11/09 06:00 [medline]
AID - 96/21/1710 [pii]
AID - 10.1136/hrt.2010.199430 [doi]
PST - ppublish
SO  - Heart. 2010 Nov;96(21):1710-5. doi: 10.1136/hrt.2010.199430.