PMID- 38286569
OWN - NLM
STAT- MEDLINE
DCOM- 20240131
LR  - 20240206
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 11
IP  - 1
DP  - 2024 Jan 29
TI  - Effect of ischaemic postconditioning on markers of myocardial injury in 
      ST-elevation myocardial infarction: a meta-analysis.
LID - 10.1136/openhrt-2023-002281 [doi]
LID - e002281
AB  - OBJECTIVES: This study aimed to perform a meta-analysis of the short-term impact 
      of ischaemic postconditioning (IPoC) on myocardial injury in ST elevation 
      myocardial infarction (STEMI) using surrogate cardiac biomarkers. METHODS: 
      Eligible studies were identified using several article databases. Randomised 
      controlled trials published between 1 January 2000 and 1 December 2021 comparing 
      IPoC to standard of therapy in STEMI patients were included in the search. 
      Outcomes included surrogates of myocardial injury, specifically peak troponin, 
      creatine-kinase (CK) and CK myoglobin binding (CK-MB) enzyme levels. RESULTS: 11 
      articles involving 1273 patients reported on CK-MB and 8 studies involving 505 
      patients reported on CK. Few studies used troponin as an outcome, thus, a 
      subanalysis of troponin dynamics was not performed. Meta-regression analysis 
      demonstrated no significant effect of IPoC on peak CK-MB (effect size -0.41, 
      95% CI -1.15 to 0.34) or peak CK (effect size -0.42, 95% CI -1.20 to 0.36). 
      Linear regression analysis demonstrated a significant correlation between a 
      history of smoking and CK-MB in the IPoC group (p=0.038). CONCLUSIONS: IPoC does 
      not seem to protect against myocardial injury in STEMI, except possibly in 
      smokers. These results resonate with some studies using imaging techniques to 
      ascertain myocardial damage. More research using troponin and cardiac imaging 
      should be pursued to better assess the effects of IPoC on cardiovascular outcomes 
      in STEMI.
CI  - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Bergman, Idan
AU  - Bergman I
AUID- ORCID: 0000-0002-4556-2547
AD  - Rabin Medical Center Beilinson Hospital, Petah Tikva, Israel 
      idanbergman@gmail.com.
AD  - Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel.
FAU - Gelikas, Shaul
AU  - Gelikas S
AD  - Sheba Medical Center, Tel Hashomer, Israel.
FAU - Wexler, Yehuda
AU  - Wexler Y
AD  - Technion Israel Institute of Technology The Ruth and Bruce Rappaport Faculty of 
      Medicine, Haifa, Israel.
FAU - Braver, Omri
AU  - Braver O
AD  - Barzilai Medical Center, Ashkelon, Israel.
AD  - Ben-Gurion University of the Negev, Beer-Sheva, Israel.
FAU - Boyle, Dennis
AU  - Boyle D
AD  - Westchester Medical Center, Valhalla, New York, USA.
FAU - Nussinovitch, Udi
AU  - Nussinovitch U
AD  - Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20240129
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
RN  - EC 2.7.3.2 (Creatine Kinase, MB Form)
RN  - EC 2.7.3.2 (Creatine Kinase)
RN  - 0 (Troponin)
RN  - 0 (Biomarkers)
SB  - IM
MH  - Humans
MH  - *ST Elevation Myocardial Infarction/diagnosis/therapy
MH  - *Myocardial Infarction/therapy
MH  - *Ischemic Postconditioning
MH  - Myocardium
MH  - Creatine Kinase, MB Form
MH  - Creatine Kinase
MH  - Troponin
MH  - Biomarkers
MH  - Randomized Controlled Trials as Topic
PMC - PMC10826564
OTO - NOTNLM
OT  - Acute Coronary Syndrome
OT  - Coronary Angiography
OT  - Coronary Stenosis
COIS- Competing interests: None declared.
EDAT- 2024/01/30 00:42
MHDA- 2024/01/31 06:43
PMCR- 2024/01/29
CRDT- 2024/01/29 21:02
PHST- 2023/08/25 00:00 [received]
PHST- 2023/10/31 00:00 [accepted]
PHST- 2024/01/31 06:43 [medline]
PHST- 2024/01/30 00:42 [pubmed]
PHST- 2024/01/29 21:02 [entrez]
PHST- 2024/01/29 00:00 [pmc-release]
AID - openhrt-2023-002281 [pii]
AID - 10.1136/openhrt-2023-002281 [doi]
PST - epublish
SO  - Open Heart. 2024 Jan 29;11(1):e002281. doi: 10.1136/openhrt-2023-002281.