Long-term effects of ischemic postconditioning on clinical outcomes: 1-year follow-up of the POST randomized trial

被引：23

作者：

Hahn, Joo-Yong ^{[1
]}

Yu, Cheol Woong ^{[2
]}

Park, Hun Sik ^{[3
]}

Song, Young Bin ^{[1
]}

Kim, Eun Kyoung ^{[1
]}

Lee, Hyun Jong ^{[4
]}

Bae, Jang-Whan ^{[5
]}

Chung, Woo-Young ^{[6
]}

Choi, Seung-Hyuk ^{[1
]}

Choi, Jin-Ho ^{[1
]}

Bae, Jang-Ho ^{[7
]}

An, Kyung Joo ^{[8
]}

Park, Jong-Seon ^{[9
]}

Oh, Ju Hyeon ^{[10
]}

Kim, Sang-Wook ^{[11
]}

Hwang, Jin-Yong ^{[12
]}

Ryu, Jae Kean ^{[13
]}

Lim, Do-Sun ^{[2
]}

Gwon, Hyeon-Cheol ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Dept Med, Div Cardiol, Samsung Med Ctr,Sch Med, Seoul 135710, South Korea

[2] Korea Univ, Anam Hosp, Seoul, South Korea

[3] Kyungpook Natl Univ Hosp, Daegu, South Korea

[4] Sejong Gen Hosp, Bucheon, South Korea

[5] Chungbuk Natl Univ, Coll Med, Cheongju, South Korea

[6] Seoul Natl Univ, Boramae Med Ctr, Seoul, South Korea

[7] Konyang Univ Hosp, Daejon, South Korea

[8] KEPCO Med Ctr, Seoul, South Korea

[9] Yeungnam Univ Hosp, Daegu, South Korea

[10] Sungkyunkwan Univ, Sch Med, Samsung Changwon Hosp, Seoul 135710, South Korea

[11] Chung Ang Univ Hosp, Seoul, South Korea

[12] Gyeongsang Natl Univ Hosp, Jinju, South Korea

[13] Daegu Catholic Univ, Med Ctr, Daegu, South Korea

来源：

AMERICAN HEART JOURNAL | 2015年 / 169卷 / 05期

关键词：

PERCUTANEOUS CORONARY INTERVENTION; ST-SEGMENT ELEVATION; ACUTE MYOCARDIAL-INFARCTION; REPERFUSION; SIZE; INHIBITION; ASPIRATION; RESOLUTION; ABCIXIMAB; THERAPY;

D O I：

10.1016/j.ahj.2015.01.015

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background In the Effects of Postconditioning on Myocardial Reperfusion in Patients with ST-segment Elevation Myocardial Infarction (POST) trial, ischemic postconditioning failed to improve myocardial reperfusion. However, long-term effects of ischemic postconditioning on clinical outcomes are not known in patients with ST-segment elevation myocardial infarction. Methods A total of 700 patients undergoing primary percutaneous coronary intervention (PCI) were randomly assigned to the postconditioning group or the conventional primary PCI group in a 1: 1 ratio. Postconditioning was performed immediately after restoration of coronary flow by balloon occlusion 4 times for 1 minute. Complete follow-up data for major clinical events at 1 year were available in 695 patients (99.3%), and analyses were done by the intention to treat principle. The primary outcome was a composite of death, myocardial infarction, severe heart failure, or stent thrombosis at 1 year. Results At 1 year, a composite of death, myocardial infarction, severe heart failure, or stent thrombosis occurred in 21 patients (6.1%) in the postconditioning group and 16 patients (4.6%) in the conventional PCI group (hazard ratio [HR] 1.32, 95% CI 0.69-2.53, P = .40). The risk of death (4.9% vs 3.7%, HR 1.32, 95% CI 0.64-2.71, P = .46), heart failure (2.6% vs 2.3%, HR 1.13, 95% CI 0.44-2.94, P = .80), and stent thrombosis (2.3% vs 1.7%, HR 1.34, 95% CI 0.46-3.85, P = .59) did not differ significantly between the 2 groups. Conclusions Ischemic postconditioning does not seem to improve the 1-year clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary PCI.

引用

页码：639 / 646

页数：8

共 25 条

[1] Relationship Between Myocardial Reperfusion, Infarct Size, and Mortality The INFUSE-AMI (Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction) Trial [J].