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Updated: Apr 19, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
[Myocardial protection of remote ischemic postconditioning during primary percutaneous coronary intervention in
1Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191,China; Department of Cardiology, Peking University International Hospital, Beijing 102206, China.
Insights
Remote ischemic postconditioning (RIPostC) improved reperfusion in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). This cardioprotective strategy reduced markers of oxidative stress and inflammation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Ischemia-Reperfusion Injury
Background:
- Acute ST-segment elevation myocardial infarction (STEMI) poses significant risks.
- Primary percutaneous coronary intervention (PCI) is a standard treatment.
- Ischemia-reperfusion injury remains a challenge post-PCI.
Purpose of the Study:
- To evaluate the cardioprotective effects of remote ischemic postconditioning (RIPostC).
- To assess RIPostC's impact on myocardial perfusion and injury markers in STEMI patients undergoing primary PCI.
Main Methods:
- Forty-six STEMI patients undergoing primary PCI were randomized into RIPostC and control groups.
- RIPostC involved cycles of ischemia/reperfusion applied to the lower limb shortly after PCI.
- Outcomes measured included enzymatic infarct size, ST-segment resolution, corrected TIMI frame count (CTFC), and plasma biomarkers (MDA, ET-1, TNFα).
Main Results:
- RIPostC significantly increased the rate of complete ST-segment resolution compared to the control group (60.9% vs. 30.4%).
- While overall CTFC did not differ significantly, anterior STEMI patients in the RIPostC group showed significantly lower CTFC.
- RIPostC led to significantly lower plasma levels of malondialdehyde (MDA), endothelin-1 (ET-1), and tumor necrosis factor α (TNFα).
Conclusions:
- RIPostC demonstrates potential cardioprotective benefits in STEMI patients undergoing primary PCI.
- The therapy may improve myocardial perfusion and reduce ischemia-reperfusion injury.
- Underlying mechanisms likely involve reduced oxidative stress, preserved endothelial function, and attenuated inflammatory responses.
Objective:
To evaluate the cardioprotection of remote ischemic postconditioning (RIPostC) in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
Methods:
Forty-six STEMI patients undergoing primary PCI at Peking University Third Hospital from January to April 2014 were randomized to RIPostC group (n=23) and control group (n=23).The RIPostC protocol was started within 1 min after reflow by thrombus aspiration or balloon inflation and consisted of 3 cycles of 5 min/5 min ischemia/reperfusion by cuff inflation/deflation of the lower left limb. The enzymatic infarct size, rate of complete ST segment resolution, corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) in infarct-related artery (IRA) and plasma levels of malondialdehyde(MDA), endothelin-1(ET-1), tumor necrosis factor α (TNFα) of the two groups were compared.
Results:
There was no significant difference in enzymatic infarct size between the two groups (P>0.05). The rate of complete ST-segment resolution was significantly higher in RIPostC group than in control group (60.9%vs. 30.4%,P=0.04). There was a trend toward lower CTFC in RIPostC group than that in control group, but the difference was not statistically significant(28 ± 11 vs. 33 ± 11, P = 0.10). However, in the subgroup of anterior wall myocardial infarction CTFC in RIPostC group was significantly lower, compared with control group (25±9 vs. 39±10, P=0.01).There were lower plasma levels of MDA,ET-1,TNFα in RIPostC group than in control group at different time points after primary PCI (P<0.05).
Conclusion:
In STEMI patients undergoing primary PCI, RIPostC may improve myocardial perfusion and attenuate ischemia reperfusion injury with the underlying mechanisms involving reduction of oxidative stress, protection of endothelial function and inhibition of inflammatory response.
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