Impact of Remote Ischemic Postconditioning during Primary Percutaneous Coronary Intervention on Left Ventricular Remodeling after Anterior Wall ST-Segment Elevation Myocardial Infarction: A Single-Center Experience
| Autor: | Ahmad E. Mostafa, Ramy Raymond, Ayman Elbadawi, Haytham Badran, Omar I. Awad, Marwan Saad |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Ejection fraction business.industry medicine.medical_treatment Percutaneous coronary intervention Thrombolysis 030204 cardiovascular system & hematology medicine.disease Coronary artery disease 03 medical and health sciences 0302 clinical medicine surgical procedures operative Internal medicine Conventional PCI Cardiology Medicine 030212 general & internal medicine Myocardial infarction cardiovascular diseases Cardiology and Cardiovascular Medicine business Ventricular remodeling TIMI |
| Zdroj: | The International journal of angiology : official publication of the International College of Angiology, Inc. 26(4) |
| ISSN: | 1061-1711 |
| Popis: | The role of remote ischemic postconditioning (RIPostC) in improving left ventricular (LV) remodeling after primary percutaneous coronary intervention (PCI) is not well established. To determine the efficacy and safety of RIPostC in improving LV remodeling and cardiovascular outcomes after primary PCI for anterior ST-elevation myocardial infarction (STEMI). Seventy-one patients with anterior STEMI were randomized to primary PCI with RIPostC protocol (n = 36) versus conventional primary PCI (n = 35). Primary outcomes included LV remodeling and LV ejection fraction (LVEF) at 6 month follow-up using transthoracic echocardiography. Secondary outcomes included infarct size, ST-segment resolution (STR) ≥70%, Thrombolysis in Myocardial Infarction (TIMI) flow grade, and myocardial blush grade (MBG). Major adverse cardiac events (MACEs) were also assessed at 6 months. Safety outcome included incidence of acute kidney injury (AKI) postprimary PCI. Sixty patients completed the study. At 6 months, there was no significant decrease in the incidence of LV remodeling with RIPostC group (p = 0.42). Similarly, RIPostC failed to show significant improvement in LVEF. However, STR ≥ 70% after primary PCI was achieved more in the RIPostC group (p = 0.04), with a trend toward less AKI in the RIPostC group (p = 0.08). All other secondary end points, including MACEs at 6 months, were similar in both groups. RIPostC might be associated with better STR after reperfusion as well as less incidence of AKI in patients undergoing primary PCI for anterior wall STEMI, indicating potential benefit in those patients. Whether this role can be translated to better outcomes after primary PCI warrants further investigation. |
| Databáze: | OpenAIRE |
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