Postconditioning with lactate-enriched blood in ST-segment elevation myocardial infarction

Background Ischemic postconditioning failed to demonstrate improved outcomes in patients with ST-segment elevation myocardial infarction (STEMI) in large-scale studies. We examined the cardioprotective effects of a modified postconditioning protocol, which was named postconditioning with lactate-enriched blood (PCLeB). Methods This study included 100 consecutive patients with STEMI treated in the Saitama Municipal Hospital within 12 h of symptom onset since March 2014 to July 2020 with one-year follow-up. PCLeB was implemented at the beginning of reperfusion. PCLeB comprised intermittent reperfusion and timely coronary injections of lactated Ringer’s solution, aimed at achieving controlled reperfusion with myocardial oxygenation and minimal washout of lactate to prolong tissue acidosis in comparison with the original protocol. Outcome measures were in-hospital and one-year mortality and re-hospitalization rates for heart failure within one year. Results In-hospital and one-year mortality were zero and none was re-hospitalized for heart failure during the one-year follow-up period among the 100 study patients. Conclusions PCLeB was associated with zero mortality and no re-hospitalization for heart failure at one year among 100 consecutive patients with STEMI who underwent reperfusion therapy.