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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Ischemic Postconditioning Before Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial

Yun-Yun Wang1, Tong Li1, Ying-Wu Liu1

  • 1Cardiac Center, Third Central Hospital of Tian Jin, Tianjin, China.

Archives of Medical Research
|December 18, 2016
PubMed

Insights

Pre-PCI ischemic postconditioning significantly reduced contrast-induced nephropathy (CIN) in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI). This intervention also improved long-term major cardiovascular event rates.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).
  • Prognosis for STEMI patients is adversely affected by CIN.
  • Ischemic postconditioning before PCI is a potential protective strategy against CIN.

Purpose of the Study:

  • To evaluate the efficacy of pre-PCI ischemic postconditioning in preventing CIN in STEMI patients.
  • To assess the impact of this intervention on long-term major adverse cardiovascular events (MACE).

Main Methods:

  • A randomized controlled trial involving 251 STEMI patients.
  • Two groups: ischemic postconditioning prior to PCI (n=123) and control (PCI only, n=128).
  • Ischemic postconditioning involved three cycles of balloon deflation/inflation (1-min ischemia/reperfusion) after infarct-related artery opening. CIN defined by creatinine increase within 48h. MACE assessed at 1-year follow-up.

Main Results:

  • The incidence of CIN was significantly lower in the ischemic postconditioning group (5.69%) compared to the control group (14.06%) (p < 0.05).
  • One-year MACE incidence was also significantly reduced in the postconditioning group (7.32%) versus the control group (15.63%) (p < 0.05).

Conclusions:

  • Pre-PCI ischemic postconditioning is an effective strategy to reduce CIN incidence in STEMI patients undergoing PCI.
  • This intervention leads to improved long-term cardiovascular outcomes.
Abstract

Keywords:
Acute myocardial infarctionContrast-induced nephropathyIschemic postconditioningLong term prognosisPercutaneous coronary intervention

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