Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction
BackgroundSmall studies suggest that postconditioning reperfusion interrupted by brief repetitive cycles of reocclusions, may protect the myocardium in the clinical setting.ObjectiveTo test the hypothesis that postconditioning limits infarct size in relation to the area at risk in patients with ST e...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2010-11, Vol.96 (21), p.1710-1715 |
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| creator | Sörensson, Peder Saleh, Nawzad Bouvier, Frederic Böhm, Felix Settergren, Magnus Caidahl, Kenneth Tornvall, Per Arheden, Håkan Rydén, Lars Pernow, John |
| description | BackgroundSmall studies suggest that postconditioning reperfusion interrupted by brief repetitive cycles of reocclusions, may protect the myocardium in the clinical setting.ObjectiveTo test the hypothesis that postconditioning limits infarct size in relation to the area at risk in patients with ST elevation myocardial infarction (STEMI).Methods76 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).ResultsThe 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.ConclusionsThis 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 informationKarolinska Clinical Trial Registration (http://www.kctr.se). Unique identifier: CT20080014. |
| doi_str_mv | 10.1136/hrt.2010.199430 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_548343</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>759324067</sourcerecordid><originalsourceid>FETCH-LOGICAL-b572t-1d8a28aa98642263d4555e79faa0c88df1496f85ad61276ea8292c38135aac143</originalsourceid><addsrcrecordid>eNqFkk1v1DAQhiMEoqVw5oYiIYSElNbxd47VUijSCg4UtOKANXHsrbfZONgJpfx6HLLdSkjAwbI9fmb8zujNsqclOi5Lwk8uw3CM0XSrKkrQveywpFwWKbS6n86EsYIjIg6yRzFuEEK0kvxhdoBRxTiV_DD7emat0UPubd77OGjfNW5wvnPdOvdd7joLIT1H99OkS97D4Ew3xPzaDZf5x4vctOY7TAn59sZrCI2D9jYrRR9nDyy00TzZ7UfZpzdnF4vzYvnh7bvF6bKomcBDUTYSsARI6ijGnDSUMWZEZQGQlrKxJa24lQwaXmLBDUhcYU1kahBAl5QcZcVcN16bfqxVH9wWwo3y4NQudJVORjEqCSWJX_6Vb8c-rTqtKcGKWtSAqapxBSrJAFUzUiprqQFdc40F--f361Quhda_q2EuEZ3kvpz5Pvhvo4mD2rqoTdtCZ_wYlWAVwRRxkcjnf5AbP4YuzVKVQiKBKkJxok5mSgcfYzB2r6BEajKKSkZRk1HUbJSU8WxXd6y3ptnzt85IwIsdAFFDawN02sU7jhDCCRZ3rbs4mB_7dwhXKskXTL3_vFD49Zfz1QohNY3q1czX281_Vf4C79njUw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1780709342</pqid></control><display><type>article</type><title>Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Sörensson, Peder ; Saleh, Nawzad ; Bouvier, Frederic ; Böhm, Felix ; Settergren, Magnus ; Caidahl, Kenneth ; Tornvall, Per ; Arheden, Håkan ; Rydén, Lars ; Pernow, John</creator><creatorcontrib>Sörensson, Peder ; Saleh, Nawzad ; Bouvier, Frederic ; Böhm, Felix ; Settergren, Magnus ; Caidahl, Kenneth ; Tornvall, Per ; Arheden, Håkan ; Rydén, Lars ; Pernow, John</creatorcontrib><description>BackgroundSmall studies suggest that postconditioning reperfusion interrupted by brief repetitive cycles of reocclusions, may protect the myocardium in the clinical setting.ObjectiveTo test the hypothesis that postconditioning limits infarct size in relation to the area at risk in patients with ST elevation myocardial infarction (STEMI).Methods76 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).ResultsThe 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.ConclusionsThis 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 informationKarolinska Clinical Trial Registration (http://www.kctr.se). Unique identifier: CT20080014.</description><identifier>ISSN: 1355-6037</identifier><identifier>ISSN: 1468-201X</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/hrt.2010.199430</identifier><identifier>PMID: 20956486</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>80 and over ; Adult ; Aged ; Aged, 80 and over ; Angioplasty ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - methods ; Balloon ; Biological and medical sciences ; Biomarkers - blood ; Cardiac and Cardiovascular Systems ; Cardiology. Vascular system ; Clinical Medicine ; coronary artery disease (CAD) ; Coronary heart disease ; coronary intervention ; Coronary/adverse effects/methods ; Creatine Kinase ; Creatine Kinase, MB Form - blood ; Electrocardiography ; Female ; Heart ; Heart attacks ; Humans ; Ischemic Preconditioning ; Ischemic Preconditioning, Myocardial - methods ; Kardiologi ; Kinases ; Klinisk medicin ; Magnetic Resonance Imaging - methods ; Male ; MB Form/blood ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Middle Aged ; MRI ; Myocardial infarction ; Myocardial Infarction - pathology ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocardial Infarction/pathology/physiopathology/therapy ; Myocardial Reperfusion Injury - etiology ; Myocardial Reperfusion Injury - prevention & control ; Myocardial Reperfusion Injury/etiology/prevention & control ; Myocardial/methods ; Myocarditis. Cardiomyopathies ; postconditioning ; Prospective Studies ; reperfusion injury ; Rodents ; STEMI ; Stroke Volume ; Studies ; Troponin T - blood</subject><ispartof>Heart (British Cardiac Society), 2010-11, Vol.96 (21), p.1710-1715</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b572t-1d8a28aa98642263d4555e79faa0c88df1496f85ad61276ea8292c38135aac143</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/96/21/1710.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/96/21/1710.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,776,780,881,3182,23551,27903,27904,77347,77378</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23336327$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20956486$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/268044$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://lup.lub.lu.se/record/1720891$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:121468270$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Sörensson, Peder</creatorcontrib><creatorcontrib>Saleh, Nawzad</creatorcontrib><creatorcontrib>Bouvier, Frederic</creatorcontrib><creatorcontrib>Böhm, Felix</creatorcontrib><creatorcontrib>Settergren, Magnus</creatorcontrib><creatorcontrib>Caidahl, Kenneth</creatorcontrib><creatorcontrib>Tornvall, Per</creatorcontrib><creatorcontrib>Arheden, Håkan</creatorcontrib><creatorcontrib>Rydén, Lars</creatorcontrib><creatorcontrib>Pernow, John</creatorcontrib><title>Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>BackgroundSmall studies suggest that postconditioning reperfusion interrupted by brief repetitive cycles of reocclusions, may protect the myocardium in the clinical setting.ObjectiveTo test the hypothesis that postconditioning limits infarct size in relation to the area at risk in patients with ST elevation myocardial infarction (STEMI).Methods76 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).ResultsThe 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.ConclusionsThis 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 informationKarolinska Clinical Trial Registration (http://www.kctr.se). Unique identifier: CT20080014.</description><subject>80 and over</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Balloon</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiac and Cardiovascular Systems</subject><subject>Cardiology. Vascular system</subject><subject>Clinical Medicine</subject><subject>coronary artery disease (CAD)</subject><subject>Coronary heart disease</subject><subject>coronary intervention</subject><subject>Coronary/adverse effects/methods</subject><subject>Creatine Kinase</subject><subject>Creatine Kinase, MB Form - blood</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Ischemic Preconditioning</subject><subject>Ischemic Preconditioning, Myocardial - methods</subject><subject>Kardiologi</subject><subject>Kinases</subject><subject>Klinisk medicin</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>MB Form/blood</subject><subject>Medical and Health Sciences</subject><subject>Medical sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Middle Aged</subject><subject>MRI</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardial Infarction/pathology/physiopathology/therapy</subject><subject>Myocardial Reperfusion Injury - etiology</subject><subject>Myocardial Reperfusion Injury - prevention & control</subject><subject>Myocardial Reperfusion Injury/etiology/prevention & control</subject><subject>Myocardial/methods</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>postconditioning</subject><subject>Prospective Studies</subject><subject>reperfusion injury</subject><subject>Rodents</subject><subject>STEMI</subject><subject>Stroke Volume</subject><subject>Studies</subject><subject>Troponin T - blood</subject><issn>1355-6037</issn><issn>1468-201X</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkk1v1DAQhiMEoqVw5oYiIYSElNbxd47VUijSCg4UtOKANXHsrbfZONgJpfx6HLLdSkjAwbI9fmb8zujNsqclOi5Lwk8uw3CM0XSrKkrQveywpFwWKbS6n86EsYIjIg6yRzFuEEK0kvxhdoBRxTiV_DD7emat0UPubd77OGjfNW5wvnPdOvdd7joLIT1H99OkS97D4Ew3xPzaDZf5x4vctOY7TAn59sZrCI2D9jYrRR9nDyy00TzZ7UfZpzdnF4vzYvnh7bvF6bKomcBDUTYSsARI6ijGnDSUMWZEZQGQlrKxJa24lQwaXmLBDUhcYU1kahBAl5QcZcVcN16bfqxVH9wWwo3y4NQudJVORjEqCSWJX_6Vb8c-rTqtKcGKWtSAqapxBSrJAFUzUiprqQFdc40F--f361Quhda_q2EuEZ3kvpz5Pvhvo4mD2rqoTdtCZ_wYlWAVwRRxkcjnf5AbP4YuzVKVQiKBKkJxok5mSgcfYzB2r6BEajKKSkZRk1HUbJSU8WxXd6y3ptnzt85IwIsdAFFDawN02sU7jhDCCRZ3rbs4mB_7dwhXKskXTL3_vFD49Zfz1QohNY3q1czX281_Vf4C79njUw</recordid><startdate>20101101</startdate><enddate>20101101</enddate><creator>Sörensson, Peder</creator><creator>Saleh, Nawzad</creator><creator>Bouvier, Frederic</creator><creator>Böhm, Felix</creator><creator>Settergren, Magnus</creator><creator>Caidahl, Kenneth</creator><creator>Tornvall, Per</creator><creator>Arheden, Håkan</creator><creator>Rydén, Lars</creator><creator>Pernow, John</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope><scope>D95</scope></search><sort><creationdate>20101101</creationdate><title>Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction</title><author>Sörensson, Peder ; Saleh, Nawzad ; Bouvier, Frederic ; Böhm, Felix ; Settergren, Magnus ; Caidahl, Kenneth ; Tornvall, Per ; Arheden, Håkan ; Rydén, Lars ; Pernow, John</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b572t-1d8a28aa98642263d4555e79faa0c88df1496f85ad61276ea8292c38135aac143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>80 and over</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Balloon</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiac and Cardiovascular Systems</topic><topic>Cardiology. Vascular system</topic><topic>Clinical Medicine</topic><topic>coronary artery disease (CAD)</topic><topic>Coronary heart disease</topic><topic>coronary intervention</topic><topic>Coronary/adverse effects/methods</topic><topic>Creatine Kinase</topic><topic>Creatine Kinase, MB Form - blood</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Ischemic Preconditioning</topic><topic>Ischemic Preconditioning, Myocardial - methods</topic><topic>Kardiologi</topic><topic>Kinases</topic><topic>Klinisk medicin</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>MB Form/blood</topic><topic>Medical and Health Sciences</topic><topic>Medical sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Middle Aged</topic><topic>MRI</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardial Infarction/pathology/physiopathology/therapy</topic><topic>Myocardial Reperfusion Injury - etiology</topic><topic>Myocardial Reperfusion Injury - prevention & control</topic><topic>Myocardial Reperfusion Injury/etiology/prevention & control</topic><topic>Myocardial/methods</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>postconditioning</topic><topic>Prospective Studies</topic><topic>reperfusion injury</topic><topic>Rodents</topic><topic>STEMI</topic><topic>Stroke Volume</topic><topic>Studies</topic><topic>Troponin T - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sörensson, Peder</creatorcontrib><creatorcontrib>Saleh, Nawzad</creatorcontrib><creatorcontrib>Bouvier, Frederic</creatorcontrib><creatorcontrib>Böhm, Felix</creatorcontrib><creatorcontrib>Settergren, Magnus</creatorcontrib><creatorcontrib>Caidahl, Kenneth</creatorcontrib><creatorcontrib>Tornvall, Per</creatorcontrib><creatorcontrib>Arheden, Håkan</creatorcontrib><creatorcontrib>Rydén, Lars</creatorcontrib><creatorcontrib>Pernow, John</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Lunds universitet</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sörensson, Peder</au><au>Saleh, Nawzad</au><au>Bouvier, Frederic</au><au>Böhm, Felix</au><au>Settergren, Magnus</au><au>Caidahl, Kenneth</au><au>Tornvall, Per</au><au>Arheden, Håkan</au><au>Rydén, Lars</au><au>Pernow, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2010-11-01</date><risdate>2010</risdate><volume>96</volume><issue>21</issue><spage>1710</spage><epage>1715</epage><pages>1710-1715</pages><issn>1355-6037</issn><issn>1468-201X</issn><eissn>1468-201X</eissn><abstract>BackgroundSmall studies suggest that postconditioning reperfusion interrupted by brief repetitive cycles of reocclusions, may protect the myocardium in the clinical setting.ObjectiveTo test the hypothesis that postconditioning limits infarct size in relation to the area at risk in patients with ST elevation myocardial infarction (STEMI).Methods76 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).ResultsThe 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.ConclusionsThis 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 informationKarolinska Clinical Trial Registration (http://www.kctr.se). Unique identifier: CT20080014.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>20956486</pmid><doi>10.1136/hrt.2010.199430</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1355-6037 |
| ispartof | Heart (British Cardiac Society), 2010-11, Vol.96 (21), p.1710-1715 |
| issn | 1355-6037 1468-201X 1468-201X |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_548343 |
| source | MEDLINE; BMJ Journals - NESLi2; PubMed Central |
| subjects | 80 and over Adult Aged Aged, 80 and over Angioplasty Angioplasty, Balloon, Coronary - adverse effects Angioplasty, Balloon, Coronary - methods Balloon Biological and medical sciences Biomarkers - blood Cardiac and Cardiovascular Systems Cardiology. Vascular system Clinical Medicine coronary artery disease (CAD) Coronary heart disease coronary intervention Coronary/adverse effects/methods Creatine Kinase Creatine Kinase, MB Form - blood Electrocardiography Female Heart Heart attacks Humans Ischemic Preconditioning Ischemic Preconditioning, Myocardial - methods Kardiologi Kinases Klinisk medicin Magnetic Resonance Imaging - methods Male MB Form/blood Medical and Health Sciences Medical sciences Medicin och hälsovetenskap Middle Aged MRI Myocardial infarction Myocardial Infarction - pathology Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocardial Infarction/pathology/physiopathology/therapy Myocardial Reperfusion Injury - etiology Myocardial Reperfusion Injury - prevention & control Myocardial Reperfusion Injury/etiology/prevention & control Myocardial/methods Myocarditis. Cardiomyopathies postconditioning Prospective Studies reperfusion injury Rodents STEMI Stroke Volume Studies Troponin T - blood |
| title | Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T21%3A52%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20postconditioning%20on%20infarct%20size%20in%20patients%20with%20ST%20elevation%20myocardial%20infarction&rft.jtitle=Heart%20(British%20Cardiac%20Society)&rft.au=S%C3%B6rensson,%20Peder&rft.date=2010-11-01&rft.volume=96&rft.issue=21&rft.spage=1710&rft.epage=1715&rft.pages=1710-1715&rft.issn=1355-6037&rft.eissn=1468-201X&rft_id=info:doi/10.1136/hrt.2010.199430&rft_dat=%3Cproquest_swepu%3E759324067%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1780709342&rft_id=info:pmid/20956486&rfr_iscdi=true |