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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Postconditioning during primary percutaneous coronary intervention: a review and meta-analysis
Peter Riis Hansen1, Helene Thibault, Jawdat Abdulla
1Department of Cardiology P, Gentofte University Hospital, DK-2900 Hellerup, Denmark. prh@dadlnet.dk
International Journal of Cardiology
|May 5, 2009
Summary
Myocardial postconditioning (POC) significantly reduces infarct size in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). This therapy improves cardiac function, offering a potential benefit over standard care.
Area of Science:
- Cardiology
- Interventional Cardiology
- Regenerative Medicine
Background:
- Reperfusion injury is a significant complication in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI).
- Myocardial postconditioning (POC), involving brief interruptions of blood flow during reperfusion, is a potential strategy to mitigate this injury.
- Evidence from small randomized trials regarding POC's efficacy in reducing infarct size in STEMI patients needs comprehensive evaluation.
Purpose of the Study:
- To systematically review and meta-analyze existing randomized trials evaluating the impact of myocardial postconditioning (POC) on myocardial infarct size.
- To assess the effect of POC on cardiac function markers in STEMI patients undergoing pPCI.
Main Methods:
- A systematic literature search was conducted using web-based databases to identify relevant randomized trials.
- Data from eligible studies were pooled for meta-analysis to determine the overall effect of POC.
Main Results:
- Six studies involving 244 STEMI patients undergoing pPCI were included.
- Meta-analysis revealed a significant reduction in peak creatine kinase levels with POC compared to standard care (WMD -609.59 IU/L, p=0.005).
- Secondary analysis showed a significant improvement in left ventricular ejection fraction with POC (WMD 4.2%, p=0.0001).
Conclusions:
- This systematic review and meta-analysis provides the first comprehensive evidence of POC's significant benefit in reducing myocardial infarct size in STEMI patients undergoing pPCI.
- POC demonstrates a positive impact on myocardial salvage and cardiac function, as indicated by reduced creatine kinase release and improved ejection fraction.
- Further research is warranted to determine the long-term clinical outcomes associated with POC in this patient population.
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