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Updated: May 11, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Effect of postconditioning on infarction size, adverse left ventricular remodeling, and improvement in left
Marek Elżbieciak1, Krystian Wita, Marek Grabka
11st Department of Cardiology, Medical University of Silesia, Katowice, Poland. elzbie20@gmail.com
Insights
Postconditioning is a safe treatment for ST-elevation myocardial infarction (STEMI) reperfusion injury. However, this study found it did not reduce infarction size, improve left ventricular ejection fraction (LVEF), or prevent adverse LV remodeling.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Research
Background:
- ST-elevation myocardial infarction (STEMI) treatment involves artery recanalization, which can cause reperfusion injury.
- Postconditioning is a potential method to mitigate this injury, but existing data on its effectiveness are conflicting.
Purpose of the Study:
- To evaluate the safety and efficacy of postconditioning in STEMI patients.
- To assess its impact on infarct size, left ventricular ejection fraction (LVEF), and left ventricular (LV) remodeling over a 3-month period.
Main Methods:
- 39 patients with anterior STEMI were randomized into traditional reperfusion or postconditioning groups.
- Area at risk (AAR) was assessed, and LV remodeling and LVEF were evaluated by echocardiography.
- Infarction size was determined by MRI at 3 months.
Main Results:
- Postconditioning did not significantly improve LVEF (OR, 1.63; P = 0.52).
- It also did not reduce the incidence of adverse LV remodeling (OR, 0.62; P = 0.5).
- No significant differences in infarction size were observed between groups after adjusting for key factors.
Conclusions:
- Postconditioning is a safe intervention for STEMI patients.
- Its application did not lead to a reduction in infarct size.
- Efficacy in improving LVEF or preventing adverse LV remodeling was not demonstrated within the 3-month follow-up.
Introduction:
A key method in the treatment of ST-elevation myocardial infarction (STEMI) is recanalization of the infarct-related artery, but this causes heart reperfusion injury. One of the methods to reduce this injury is postconditioning. The available data on the efficacy of this method are contradictory.
Objectives:
The aim of the study was to determine the safety of postconditioning as well as its effect on infarction size, improvement in left ventricular ejection fraction (LVEF), and adverse LV remodeling during a 3-month follow-up.
Patients And Methods:
The study involved 39 patients with first anterior STEMI (aged 58 ± 10 years) up to 12 hours from the onset of symptoms. They were randomly assigned to a traditional-reperfusion group (n = 21) or to a postconditioning group (n = 18). The area at risk (AAR) was assessed angiographically. LV remodeling and LVEF were evaluated using echocardiography at 6 days and at 3 months. The infarction size was defined on the basis of magnetic resonance imaging (MRI) at 3 months.
Results:
In a univariate logistic regression analysis, postconditioning did not affect the improvement of LVEF (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.34-7.7; P = 0.52) or the development of adverse LV remodeling (OR, 0.62; 95% CI, 0.15-2.53; P = 0.5). Moreover, there were no significant differences in infarction size between the groups as measured by MRI after adjustment for the AAR, time to reperfusion, and ST-segment elevation prior to percutaneous coronary intervention.
Conclusions:
Postconditioning is a safe method but its application did not affect the volume of the infarction as well as did not improve LVEF or the development of adverse LV remodeling in a 3-month follow-up.
