Mechanical ischaemic postconditioning significantly reduced infarct size compared to control (71.7 vs 88.2x10^3 arbitrary units; p=0.027), an effect uninfluenced by traditional risk factors.
Meta-Analysis (n=173)
Open-label
Randomized
Yes
Does mechanical ischaemic postconditioning reduce infarct size in STEMI patients undergoing PCI, and is this effect modified by traditional cardiovascular risk factors?
Mechanical ischaemic postconditioning reduces infarct size in STEMI patients, and this cardioprotective effect is maintained regardless of traditional cardiovascular risk factors.
Absolute Event Rate: 71.7% vs 88.2%
p-value: p=0.027
OBJECTIVE: Previous studies have shown that mechanical postconditioning (PostC) significantly reduces infarct size (IS) in patients with acute myocardial infarction. Our objective was to assess the influence of traditional cardiovascular (CV) risk factors on IS and their interaction with ischaemic PostC in patients with acute ST-elevation myocardial infarction (STEMI). METHODS: The study population was constituted from the clinical database pooling of four previously published PostC prospective, multicentre, randomised, open-label controlled trials with identical inclusion criteria. Patients with STEMI, presenting within 12 h of symptoms onset referred for percutaneous coronary intervention, were included. Mechanical ischaemic PostC was performed by four repeated cycles of inflation-deflation of the angioplasty balloon within 1 min of reflow, while the control group underwent no intervention. IS was assessed by measuring total creatine kinase release over 72 h. RESULTS: 173 patients, aged 58±12 years, 76% males, 48% anterior infarct were included (82 in the PostC group, 91 in the control group). IS was significantly reduced in the PostC compared to the control group (71.7±41.6 vs 88.2±54.5×10(3) arbitrary units; p=0.027). After adjustment for abnormally contracting segments, older patients had smaller IS and smokers had larger IS. Gender, diabetes, hypertension, dyslipidemia and obesity did not have any significant effect on IS. Multivariate regression analysis showed that none of the traditional risk factors had a significant impact on the cardioprotective effect of mechanical ischaemic PostC. CONCLUSIONS: The present analysis suggests that the cardioprotective effect of mechanical PostC is not influenced by traditional CV risk factors that are prevalent in patients with STEMI.
Pichot et al. (Sat,) conducted a meta-analysis in ST-elevation myocardial infarction (STEMI) (n=173). Mechanical ischaemic postconditioning vs. No intervention was evaluated on Infarct size assessed by measuring total creatine kinase release over 72 h (p=0.027). Mechanical ischaemic postconditioning significantly reduced infarct size compared to control (71.7 vs 88.2x10^3 arbitrary units; p=0.027), an effect uninfluenced by traditional risk factors.