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Updated: Nov 2, 2025
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Long-term outcomes of ischemic post-conditioning primary PCI and conventional primary PCI in acute STEMI: a
Tanveer Mir1, Mohammed Uddin1, Khalid Hamid Changal2
1Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
Insights
Ischemic postconditioning during percutaneous coronary intervention (PCI) in STEMI patients showed no long-term benefits compared to conventional PCI alone. This meta-analysis found no significant differences in heart failure, myocardial infarction, or mortality rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Trials
Background:
- Conflicting data exists on the efficacy of ischemic postconditioning during percutaneous coronary intervention (PCI).
- The role of this technique in ST-elevation myocardial infarction (STEMI) patients requires further clarification.
Purpose of the Study:
- To evaluate the long-term benefits of ischemic postconditioning during PCI (ICP-PPCI) compared to conventional PCI alone in STEMI patients.
- To assess the impact of ICP-PPCI on major adverse cardiac events, including heart failure, myocardial infarction, and mortality.
Main Methods:
- A systematic review and meta-analysis of online databases was conducted.
- Eight studies involving 2,566 STEMI patients were analyzed.
- Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model.
Main Results:
- No significant differences were observed between ICP-PPCI and conventional PCI regarding heart failure (RR 0.87, p=0.29), myocardial infarction (RR 1.28, p=0.20), mortality (RR 0.93, p=0.58), or major adverse cardiac events (RR 0.89, p=0.22).
- Long-term follow-up (≥1 year) showed comparable composite event rates between the two groups (RR 1.00, p=1.00).
- Patient demographics were similar between the ICP-PPCI and PPCI groups.
Conclusions:
- Ischemic postconditioning during PCI in STEMI patients does not offer long-term advantages over conventional PCI.
- The findings suggest that ICP-PPCI is not superior to standard PCI in improving clinical outcomes.
Background:
Data regarding ischemic postconditioning during percutaneous coronary intervention (PCI) as compared conventional PCI alone has yielded conflicting results.
Methods:
Online databases comparing use of ischemic postconditioning percutaneous coronary intervention (ICP-PPCI) in STEMI patients with conventional PPCI were selected. Mortality, heart failure (HF), myocardial infarction (MI), and major adverse cardiac events (MACE) were evaluated. The primary outcome was composite of HF, MI, and mortality. Pooled risk ratio (RR) with 95% confidence interval (CI) were computed using random-effects model.
Results:
Eight studies consisting of 2,566 patients (ICP-PPCI n = 1,228; PPCI n = 1,278) were included. The mean age for PPCI group was 61.38 ± 7.86 years (51% men) and for PCI 59.83 ± 8.94 years (47% men). There were no differences in outcome between ICP-PPCI and PPCI in terms of HF (RR 0.87 95% CI0.51-1.48; p = 0.29), MI (RR 1.28, 95%CI0.74-2.20; p = 0.20), mortality (RR 0.93, 95%CI0.64-1.34; p = 0.58), and MACE (RR 0.89, 95%CI0.74-1.07; p = 0.22). The results for composite event for the ICP-PPCI and PPIC procedures, at ≥1 year follow-up duration, were comparable (RR 1.00 95%CI0.82-1.22; p = 1).
Conclusion:
Ischemic postconditioning post percutaneous coronary intervention in STEMI patients has no long-term benefits over conventional PCI.
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