PMID- 23530474
OWN - NLM
STAT- MEDLINE
DCOM- 20130708
LR  - 20211021
IS  - 1471-2261 (Electronic)
IS  - 1471-2261 (Linking)
VI  - 13
DP  - 2013 Mar 25
TI  - Long-term impact of postconditioning on infarct size and left ventricular 
      ejection fraction in patients with ST-elevation myocardial infarction.
PG  - 22
LID - 10.1186/1471-2261-13-22 [doi]
AB  - BACKGROUND: Ischemic postconditioning (PostC), reperfusion in brief cycles, is 
      known to induce short-term reduction in infarct size in patients with ST 
      elevation myocardial infarction (STEMI), especially among those with large 
      myocardium at risk (MaR). The aim of the present study was to investigate the 
      long-term effect of PostC on infarct size and left ventricular ejection fraction 
      (LVEF). METHODS: Sixty-eight patients with a first STEMI were randomised to 
      primary percutaneous coronary intervention (PCI) (n = 35) or PCI followed by 
      PostC (n = 33). MaR was determined as abnormally contracting segments on left 
      ventricular angiogram. Cardiac magnetic resonance was performed at 3 and 12 
      months for the determination of infarct size and LVEF. RESULTS: Overall there was 
      no difference in infarct size expressed in percentage of MaR between patients 
      randomised to the control (31%; 23, 41) and PostC (31%; 23, 43) groups at 12 
      months. Likewise there was no difference in LVEF between control (49%; 41, 55) 
      and PostC (52%; 45, 55). In contrast, patients in the PostC group with MaR in the 
      upper quartile had a significantly smaller infarct size (29%; 18, 38) than those 
      in the control group (40%; 34, 48; p < 0.05) at 12 months. In these patients LVEF 
      was higher in the PostC (47%; 43, 50) compared to the control group (38%; 34, 42; 
      p < 0.01). CONCLUSIONS: In this long-term follow-up study PostC did not reduce 
      infarct size in relation to MaR or improved LVEF in the overall study population. 
      However, the present data suggest that PostC exerts long-term beneficial effects 
      in patients with large MaR thereby extending previously published short-term 
      observations. TRIAL REGISTRATION: Karolinska Clinical Trial Registration 
      (http://www.kctr.se). Unique identifier: CT20080014.
FAU - Sorensson, Peder
AU  - Sorensson P
AD  - Karolinska Institutet, Department of Medicine, Unit of Cardiology, Karolinska 
      University Hospital, Stockholm, Sweden. peder.sorensson@karolinska.se
FAU - Ryden, Lars
AU  - Ryden L
FAU - Saleh, Nawsad
AU  - Saleh N
FAU - Tornvall, Per
AU  - Tornvall P
FAU - Arheden, Hakan
AU  - Arheden H
FAU - Pernow, John
AU  - Pernow J
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20130325
PL  - England
TA  - BMC Cardiovasc Disord
JT  - BMC cardiovascular disorders
JID - 100968539
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Combined Modality Therapy
MH  - Female
MH  - Humans
MH  - *Ischemic Postconditioning
MH  - Linear Models
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/pathology/physiopathology/*therapy
MH  - Myocardium/*pathology
MH  - *Percutaneous Coronary Intervention
MH  - Predictive Value of Tests
MH  - Recovery of Function
MH  - *Stroke Volume
MH  - Sweden
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Function, Left
PMC - PMC3618137
EDAT- 2013/03/28 06:00
MHDA- 2013/07/09 06:00
PMCR- 2013/03/25
CRDT- 2013/03/28 06:00
PHST- 2012/06/28 00:00 [received]
PHST- 2013/03/18 00:00 [accepted]
PHST- 2013/03/28 06:00 [entrez]
PHST- 2013/03/28 06:00 [pubmed]
PHST- 2013/07/09 06:00 [medline]
PHST- 2013/03/25 00:00 [pmc-release]
AID - 1471-2261-13-22 [pii]
AID - 10.1186/1471-2261-13-22 [doi]
PST - epublish
SO  - BMC Cardiovasc Disord. 2013 Mar 25;13:22. doi: 10.1186/1471-2261-13-22.