Long-term Follow-up of Patients Undergoing Postconditioning During ST-Elevation Myocardial Infarction
Reperfusion injury may offset the optimal salvage of myocardium achieved during primary coronary angioplasty. Thus, coronary reperfusion must be combined with cardioprotective adjunctive therapies in order to optimize myocardial salvage and minimize infarct size. Forty-three patients with their firs...
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| Veröffentlicht in: | Journal of cardiovascular translational research 2011-02, Vol.4 (1), p.92-98 |
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| creator | Garcia, Santiago Henry, Timothy D. Wang, Yale L. Chavez, Ivan J. Pedersen, Wesley R. Lesser, John R. Shroff, Gautam R. Moore, Luke Traverse, Jay H. |
| description | Reperfusion injury may offset the optimal salvage of myocardium achieved during primary coronary angioplasty. Thus, coronary reperfusion must be combined with cardioprotective adjunctive therapies in order to optimize myocardial salvage and minimize infarct size. Forty-three patients with their first ST-elevation myocardial infarction were randomized to myocardial postconditioning or standard of care at the time of primary coronary angioplasty. Postconditioning was performed immediately upon crossing the lesion with the guide wire and consisted of four cycles of 30 s occlusion followed by 30 s of reperfusion. End-points included infarct size, myocardial perfusion grade (MPG), left-ventricular ejection fraction (LVEF), and long-term clinical events (death and heart failure). Despite similar ischemic times (≅4.5 h) (
p
= 0.9) a reduction in infarct size was observed among patients treated with the postconditioning protocol. Peak creatine phosphokinase (CPK), as well as its myocardial band (MB) fraction, was significantly lower in the postconditioning group when compared with the control group (CPK—control, 2,444 ± 1,928 IU/L vs. PC, 2,182 ± 1,717 IU/L; CPK-MB—control, 242 ± 40 IU/L vs. PC, 195 ± 33 IU/L;
p
= 0.64 and
p
|
| doi_str_mv | 10.1007/s12265-010-9252-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_837454774</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>837454774</sourcerecordid><originalsourceid>FETCH-LOGICAL-c343t-bcdea83fdb42aa7c833a7e7984aed8951b49fe7eb0fbc05a7a0d2e0fce2f112a3</originalsourceid><addsrcrecordid>eNp9kM1OwzAQhC0EoqXwAFxQbpwM_knq5IhKC5WKqER7thxnXaVK7GInoL49iVI4cprVaGak_RC6peSBEiIeA2VsmmBCCc5YwjA5Q2OacYETniXnf3cqRugqhD0hU0aEuEQjRimfckrGCFbO7nADvo4WrqrcN24PkTPRWjUl2CZEW1uA37nS7qK1C412tiib0tneeG59Lx8bPK_gS_V29HZ0WvmiVFW0tEZ53bvX6MKoKsDNSSdou5hvZq949f6ynD2tsOYxb3CuC1ApN0UeM6WETjlXAkSWxgqKNEtoHmcGBOTE5JokSihSMCBGAzOUMsUn6H7YPXj32UJoZF0GDVWlLLg2yJSLOImFiLskHZLauxA8GHnwZa38UVIie7hygCs7uLKHK0nXuTutt3kNxV_jl2YXYEMgHHow4OXetd52H_-z-gN--Ic5</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>837454774</pqid></control><display><type>article</type><title>Long-term Follow-up of Patients Undergoing Postconditioning During ST-Elevation Myocardial Infarction</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Garcia, Santiago ; Henry, Timothy D. ; Wang, Yale L. ; Chavez, Ivan J. ; Pedersen, Wesley R. ; Lesser, John R. ; Shroff, Gautam R. ; Moore, Luke ; Traverse, Jay H.</creator><creatorcontrib>Garcia, Santiago ; Henry, Timothy D. ; Wang, Yale L. ; Chavez, Ivan J. ; Pedersen, Wesley R. ; Lesser, John R. ; Shroff, Gautam R. ; Moore, Luke ; Traverse, Jay H.</creatorcontrib><description>Reperfusion injury may offset the optimal salvage of myocardium achieved during primary coronary angioplasty. Thus, coronary reperfusion must be combined with cardioprotective adjunctive therapies in order to optimize myocardial salvage and minimize infarct size. Forty-three patients with their first ST-elevation myocardial infarction were randomized to myocardial postconditioning or standard of care at the time of primary coronary angioplasty. Postconditioning was performed immediately upon crossing the lesion with the guide wire and consisted of four cycles of 30 s occlusion followed by 30 s of reperfusion. End-points included infarct size, myocardial perfusion grade (MPG), left-ventricular ejection fraction (LVEF), and long-term clinical events (death and heart failure). Despite similar ischemic times (≅4.5 h) (
p
= 0.9) a reduction in infarct size was observed among patients treated with the postconditioning protocol. Peak creatine phosphokinase (CPK), as well as its myocardial band (MB) fraction, was significantly lower in the postconditioning group when compared with the control group (CPK—control, 2,444 ± 1,928 IU/L vs. PC, 2,182 ± 1,717 IU/L; CPK-MB—control, 242 ± 40 IU/L vs. PC, 195 ± 33 IU/L;
p
= 0.64 and
p
< 0.01, respectively). EF in the postconditioning group was improved when compared with the control group (control, 43% ± 15 vs. PC, 52% ± 9;
p
= 0.05). After a mean follow-up of 3.4 years, a 6-point absolute difference in LVEF was still evident in the postconditioning group (
p
= 0.18). MPG was better among patients treated with the postconditioning protocol compared with control (2.5 ± 0.5 vs. 2.1 ± 0.6;
p
= 0.02). Due to the small sample size no significant differences in clinical events were detected (
p
value for death = 0.9;
p
value for heart failure = 0.2). A simple postconditioning protocol applied at the onset of mechanical reperfusion, resulted in reduction of infarct size, better epicardial and myocardial flow, and improvement in left ventricular function. The beneficial effects of postconditioning on cardiac function persist beyond 3 years.</description><identifier>ISSN: 1937-5387</identifier><identifier>EISSN: 1937-5395</identifier><identifier>DOI: 10.1007/s12265-010-9252-0</identifier><identifier>PMID: 21136310</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Aged ; Angioplasty, Balloon, Coronary ; Biomarkers - blood ; Biomedical Engineering and Bioengineering ; Biomedicine ; Cardiology ; Coronary Circulation ; Creatine Kinase, MB Form - blood ; Female ; Follow-Up Studies ; Human Genetics ; Humans ; Ischemic Postconditioning ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minnesota ; Myocardial Infarction - pathology ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocardial Reperfusion Injury - pathology ; Myocardial Reperfusion Injury - physiopathology ; Myocardial Reperfusion Injury - prevention & control ; Myocardium - pathology ; Pilot Projects ; Stroke Volume ; Time Factors ; Treatment Outcome ; Ventricular Function, Left</subject><ispartof>Journal of cardiovascular translational research, 2011-02, Vol.4 (1), p.92-98</ispartof><rights>Springer Science+Business Media, LLC 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c343t-bcdea83fdb42aa7c833a7e7984aed8951b49fe7eb0fbc05a7a0d2e0fce2f112a3</citedby><cites>FETCH-LOGICAL-c343t-bcdea83fdb42aa7c833a7e7984aed8951b49fe7eb0fbc05a7a0d2e0fce2f112a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12265-010-9252-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12265-010-9252-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21136310$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garcia, Santiago</creatorcontrib><creatorcontrib>Henry, Timothy D.</creatorcontrib><creatorcontrib>Wang, Yale L.</creatorcontrib><creatorcontrib>Chavez, Ivan J.</creatorcontrib><creatorcontrib>Pedersen, Wesley R.</creatorcontrib><creatorcontrib>Lesser, John R.</creatorcontrib><creatorcontrib>Shroff, Gautam R.</creatorcontrib><creatorcontrib>Moore, Luke</creatorcontrib><creatorcontrib>Traverse, Jay H.</creatorcontrib><title>Long-term Follow-up of Patients Undergoing Postconditioning During ST-Elevation Myocardial Infarction</title><title>Journal of cardiovascular translational research</title><addtitle>J. of Cardiovasc. Trans. Res</addtitle><addtitle>J Cardiovasc Transl Res</addtitle><description>Reperfusion injury may offset the optimal salvage of myocardium achieved during primary coronary angioplasty. Thus, coronary reperfusion must be combined with cardioprotective adjunctive therapies in order to optimize myocardial salvage and minimize infarct size. Forty-three patients with their first ST-elevation myocardial infarction were randomized to myocardial postconditioning or standard of care at the time of primary coronary angioplasty. Postconditioning was performed immediately upon crossing the lesion with the guide wire and consisted of four cycles of 30 s occlusion followed by 30 s of reperfusion. End-points included infarct size, myocardial perfusion grade (MPG), left-ventricular ejection fraction (LVEF), and long-term clinical events (death and heart failure). Despite similar ischemic times (≅4.5 h) (
p
= 0.9) a reduction in infarct size was observed among patients treated with the postconditioning protocol. Peak creatine phosphokinase (CPK), as well as its myocardial band (MB) fraction, was significantly lower in the postconditioning group when compared with the control group (CPK—control, 2,444 ± 1,928 IU/L vs. PC, 2,182 ± 1,717 IU/L; CPK-MB—control, 242 ± 40 IU/L vs. PC, 195 ± 33 IU/L;
p
= 0.64 and
p
< 0.01, respectively). EF in the postconditioning group was improved when compared with the control group (control, 43% ± 15 vs. PC, 52% ± 9;
p
= 0.05). After a mean follow-up of 3.4 years, a 6-point absolute difference in LVEF was still evident in the postconditioning group (
p
= 0.18). MPG was better among patients treated with the postconditioning protocol compared with control (2.5 ± 0.5 vs. 2.1 ± 0.6;
p
= 0.02). Due to the small sample size no significant differences in clinical events were detected (
p
value for death = 0.9;
p
value for heart failure = 0.2). A simple postconditioning protocol applied at the onset of mechanical reperfusion, resulted in reduction of infarct size, better epicardial and myocardial flow, and improvement in left ventricular function. The beneficial effects of postconditioning on cardiac function persist beyond 3 years.</description><subject>Adult</subject><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Biomarkers - blood</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Biomedicine</subject><subject>Cardiology</subject><subject>Coronary Circulation</subject><subject>Creatine Kinase, MB Form - blood</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Ischemic Postconditioning</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minnesota</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardial Reperfusion Injury - pathology</subject><subject>Myocardial Reperfusion Injury - physiopathology</subject><subject>Myocardial Reperfusion Injury - prevention & control</subject><subject>Myocardium - pathology</subject><subject>Pilot Projects</subject><subject>Stroke Volume</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Function, Left</subject><issn>1937-5387</issn><issn>1937-5395</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1OwzAQhC0EoqXwAFxQbpwM_knq5IhKC5WKqER7thxnXaVK7GInoL49iVI4cprVaGak_RC6peSBEiIeA2VsmmBCCc5YwjA5Q2OacYETniXnf3cqRugqhD0hU0aEuEQjRimfckrGCFbO7nADvo4WrqrcN24PkTPRWjUl2CZEW1uA37nS7qK1C412tiib0tneeG59Lx8bPK_gS_V29HZ0WvmiVFW0tEZ53bvX6MKoKsDNSSdou5hvZq949f6ynD2tsOYxb3CuC1ApN0UeM6WETjlXAkSWxgqKNEtoHmcGBOTE5JokSihSMCBGAzOUMsUn6H7YPXj32UJoZF0GDVWlLLg2yJSLOImFiLskHZLauxA8GHnwZa38UVIie7hygCs7uLKHK0nXuTutt3kNxV_jl2YXYEMgHHow4OXetd52H_-z-gN--Ic5</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Garcia, Santiago</creator><creator>Henry, Timothy D.</creator><creator>Wang, Yale L.</creator><creator>Chavez, Ivan J.</creator><creator>Pedersen, Wesley R.</creator><creator>Lesser, John R.</creator><creator>Shroff, Gautam R.</creator><creator>Moore, Luke</creator><creator>Traverse, Jay H.</creator><general>Springer US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Long-term Follow-up of Patients Undergoing Postconditioning During ST-Elevation Myocardial Infarction</title><author>Garcia, Santiago ; Henry, Timothy D. ; Wang, Yale L. ; Chavez, Ivan J. ; Pedersen, Wesley R. ; Lesser, John R. ; Shroff, Gautam R. ; Moore, Luke ; Traverse, Jay H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-bcdea83fdb42aa7c833a7e7984aed8951b49fe7eb0fbc05a7a0d2e0fce2f112a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Biomarkers - blood</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Biomedicine</topic><topic>Cardiology</topic><topic>Coronary Circulation</topic><topic>Creatine Kinase, MB Form - blood</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Ischemic Postconditioning</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minnesota</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardial Reperfusion Injury - pathology</topic><topic>Myocardial Reperfusion Injury - physiopathology</topic><topic>Myocardial Reperfusion Injury - prevention & control</topic><topic>Myocardium - pathology</topic><topic>Pilot Projects</topic><topic>Stroke Volume</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Garcia, Santiago</creatorcontrib><creatorcontrib>Henry, Timothy D.</creatorcontrib><creatorcontrib>Wang, Yale L.</creatorcontrib><creatorcontrib>Chavez, Ivan J.</creatorcontrib><creatorcontrib>Pedersen, Wesley R.</creatorcontrib><creatorcontrib>Lesser, John R.</creatorcontrib><creatorcontrib>Shroff, Gautam R.</creatorcontrib><creatorcontrib>Moore, Luke</creatorcontrib><creatorcontrib>Traverse, Jay H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular translational research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garcia, Santiago</au><au>Henry, Timothy D.</au><au>Wang, Yale L.</au><au>Chavez, Ivan J.</au><au>Pedersen, Wesley R.</au><au>Lesser, John R.</au><au>Shroff, Gautam R.</au><au>Moore, Luke</au><au>Traverse, Jay H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Follow-up of Patients Undergoing Postconditioning During ST-Elevation Myocardial Infarction</atitle><jtitle>Journal of cardiovascular translational research</jtitle><stitle>J. of Cardiovasc. Trans. Res</stitle><addtitle>J Cardiovasc Transl Res</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>4</volume><issue>1</issue><spage>92</spage><epage>98</epage><pages>92-98</pages><issn>1937-5387</issn><eissn>1937-5395</eissn><abstract>Reperfusion injury may offset the optimal salvage of myocardium achieved during primary coronary angioplasty. Thus, coronary reperfusion must be combined with cardioprotective adjunctive therapies in order to optimize myocardial salvage and minimize infarct size. Forty-three patients with their first ST-elevation myocardial infarction were randomized to myocardial postconditioning or standard of care at the time of primary coronary angioplasty. Postconditioning was performed immediately upon crossing the lesion with the guide wire and consisted of four cycles of 30 s occlusion followed by 30 s of reperfusion. End-points included infarct size, myocardial perfusion grade (MPG), left-ventricular ejection fraction (LVEF), and long-term clinical events (death and heart failure). Despite similar ischemic times (≅4.5 h) (
p
= 0.9) a reduction in infarct size was observed among patients treated with the postconditioning protocol. Peak creatine phosphokinase (CPK), as well as its myocardial band (MB) fraction, was significantly lower in the postconditioning group when compared with the control group (CPK—control, 2,444 ± 1,928 IU/L vs. PC, 2,182 ± 1,717 IU/L; CPK-MB—control, 242 ± 40 IU/L vs. PC, 195 ± 33 IU/L;
p
= 0.64 and
p
< 0.01, respectively). EF in the postconditioning group was improved when compared with the control group (control, 43% ± 15 vs. PC, 52% ± 9;
p
= 0.05). After a mean follow-up of 3.4 years, a 6-point absolute difference in LVEF was still evident in the postconditioning group (
p
= 0.18). MPG was better among patients treated with the postconditioning protocol compared with control (2.5 ± 0.5 vs. 2.1 ± 0.6;
p
= 0.02). Due to the small sample size no significant differences in clinical events were detected (
p
value for death = 0.9;
p
value for heart failure = 0.2). A simple postconditioning protocol applied at the onset of mechanical reperfusion, resulted in reduction of infarct size, better epicardial and myocardial flow, and improvement in left ventricular function. The beneficial effects of postconditioning on cardiac function persist beyond 3 years.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>21136310</pmid><doi>10.1007/s12265-010-9252-0</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Angioplasty, Balloon, Coronary Biomarkers - blood Biomedical Engineering and Bioengineering Biomedicine Cardiology Coronary Circulation Creatine Kinase, MB Form - blood Female Follow-Up Studies Human Genetics Humans Ischemic Postconditioning Male Medicine Medicine & Public Health Middle Aged Minnesota Myocardial Infarction - pathology Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocardial Reperfusion Injury - pathology Myocardial Reperfusion Injury - physiopathology Myocardial Reperfusion Injury - prevention & control Myocardium - pathology Pilot Projects Stroke Volume Time Factors Treatment Outcome Ventricular Function, Left |
| title | Long-term Follow-up of Patients Undergoing Postconditioning During ST-Elevation Myocardial Infarction |
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