Key result
The PORT trial is designed to test whether ischemic postconditioning after thrombus aspiration reduces infarct size at 3 months in 72 STEMI patients undergoing primary PCI.
Why the study?
Does ischemic postconditioning immediately after routine thrombus aspiration reduce infarct size in patients with STEMI undergoing primary PCI?
RCT (n=72)
Open-label
1:1
Yes
Does ischemic postconditioning immediately after routine thrombus aspiration reduce infarct size in patients with STEMI undergoing primary PCI?
The PORT trial is designed to evaluate whether adding ischemic postconditioning to routine thrombus aspiration reduces infarct size in patients with STEMI undergoing primary PCI.
Addresses open question of postconditioning benefit in STEMI; RCT extends evidence on infarct size reduction beyond thrombus aspiration.
BACKGROUND: Whether ischemic postconditioning (IPOC) immediately after routine thrombus aspiration (TA) reduces infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been established. STUDY DESIGN: The POstconditioning Rotterdam Trial (PORT) is a dual-center, prospective, open-label, randomized trial with blinded endpoint evaluation enrolling 72 subjects with first-time STEMI, and an occluded infarct-related artery (IRA) without collaterals undergoing PPCI. Subjects are randomized 1:1 to a strategy of IPOC immediately after TA followed by stenting of the IRA or to conventional percutaneous coronary intervention (PCI), including TA followed by stenting of the IRA (controls). Cardiac magnetic resonance imaging (MRI) is performed at 3-5 days after STEMI and at 3 months. The primary endpoint is IS at 3 months measured by delayed enhancement MRI. Other secondary endpoints include MRI-derived microvascular obstruction (MVO), left ventricular ejection fraction, myocardial salvage index, enzymatic IS, ST-segment resolution, myocardial blush grade, microcirculatory resistance, inflammation markers, and clinical events through 3-month follow-up. CONCLUSIONS: PORT is testing the hypothesis that adding IPOC (against lethal reperfusion injury) to TA (against distal embolization and MVO) is cardioprotective and reduces ultimate IS in STEMI patients undergoing PPCI (Dutch Trial Register identifier: NTR4040).
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Yetgin et al. (2015) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=72). Ischemic postconditioning (IPOC) immediately after thrombus aspiration followed by stenting vs. Conventional PCI including thrombus aspiration followed by stenting was evaluated on Infarct size at 3 months measured by delayed enhancement MRI. The PORT trial is designed to test whether ischemic postconditioning after thrombus aspiration reduces infarct size at 3 months in 72 STEMI patients undergoing primary PCI.
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