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Updated: Jun 10, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Postconditioning the human heart in percutaneous coronary intervention
Feng Xue1, Xiangjun Yang, Bing Zhang
1Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Insights
Postconditioning (PC) significantly reduces heart muscle damage and improves heart function after ST-segment elevation myocardial infarction (MI). This technique, applied before stenting, offers a valuable modification to primary percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Interventional Cardiology
- Myocardial Reperfusion Injury
Background:
- Animal models demonstrate postconditioning (PC) attenuates reperfusion injury.
- Clinical evidence for PC application in ST-segment elevation myocardial infarction (MI) is limited.
Purpose of the Study:
- To evaluate the efficacy of PC as an adjunct to primary percutaneous coronary intervention (PCI) in patients with acute MI.
- To assess the impact of PC on infarct size, cardiac biomarkers, and left ventricular function.
Main Methods:
- Forty-three acute MI patients were randomized into a control group (primary PCI alone) and a PC group.
- PC involved four cycles of 1-minute balloon inflation/deflation before stenting.
- Cardiac biomarkers (CK-MB, hs-CRP), ECG, echocardiography, and SPECT myocardial perfusion imaging were utilized.
Main Results:
- The PC group showed significantly lower peak CK-MB levels and CK-MB area under the curve.
- Reduced hs-CRP levels and improved ST-segment resolution were observed in the PC group.
- PC significantly reduced infarct size (by 46%) and improved left ventricle ejection fraction compared to controls.
Conclusions:
- PC is a valuable modification of primary PCI for acute MI.
- This intervention effectively reduces myocardial damage and improves cardiac function post-reperfusion.
Background:
It has been proved in animal models that postconditioning (PC) could attenuate reperfusion injury. But there are not many clinical studies on the application of PC.
Hypothesis:
Four cycles of 1-minute balloon inflation and deflation, following initial balloon reperfusion in ST-segment elevation myocardial infarction (MI) but before stenting, might improve clinical outcomes compared with primary percutaneous coronary intervention (PCI) alone.
Methods:
Forty-three patients diagnosed with acute MI were randomly assigned to 2 groups: the control group (n = 20) and the PC group (n = 23). Blood samples were obtained and assayed for creatine kinase MB (CK-MB) and high-sensitive C-reactive protein. Electrocardiogram, echocardiography, and rest technetium Tc 99m-sestamibi (99mTc-MIBI) myocardial perfusion single-photon emission computed tomography (SPECT) were performed.
Results:
The control group presented with higher peak CK-MB as compared with the PC group (351.9 +/- 153.6 vs 247.7 +/- 118.3 U/L, P = 0.028) as well as the area under the curve (AUC) of CK-MB (8040 +/- 3358 vs 5955 +/- 2509, P = 0.04). After PCI, PC was associated with a lower level of hs-CRP in comparison with the control group (5.5 +/- 4.5 vs 9.5 +/- 5.2 mg/L, P = 0.019). More patients in the PC group had complete ST-segment resolution than did patients in the control group (82.6% vs 45.0%, P = 0.049). Left ventricle ejection fraction was better in the PC group than in the control group (0.57 +/- 0.09 vs 0.47 +/- 0.11, P = 0.002). Compared with the control group, PC greatly reduced infarct size, by 46% as measured by SPECT (13 +/- 11.2% vs 24.2 +/- 10.6%, P = 0.002).
Conclusions:
This study indicated that PC in emergent PCI was a valuable modification of primary PCI.
