Lack of Benefit of Ischemic Postconditioning After Routine Thrombus Aspiration During Reperfusion: Immediate and Midterm Results

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Andre Luz (Author) Other; Mario Santos (Author) Other; Rui Magalhaes (Author) ICBAS; Joao Silveira (Author) Other; Sofia Cabral (Author) Other; Vasco Dias (Author) Other; Filomena Oliveira (Author) Other; Sousa Pereira (Author) Other; Adelino Leite Moreira (Author) Other; Henrique Carvalho (Author) Other; Severo Torres (Author) Other

Journal

Title: Journal of Cardiovascular Pharmacology and Therapeutics

Vol. 20

Pages: 523-531

ISSN: 1074-2484

Publisher: SAGE

Indexing

ISI Web of Knowledge - 13 Citations

Scopus - 13 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-00G-R02

DOI: 10.1177/1074248415578171

Abstract (EN): Objectives: The underutilization of manual thrombus aspiration (MTA) may have reduced the benefits of ischemic postconditioning (PostCon), as it reduces thrombus embolization. We aimed to assess the benefits of PostCon in patients with ST-segment elevation myocardial infarction (STEMI) after the systematic utilization of MTA. Methods: A total of 87 patients were enrolled in a prospective, randomized trial (43 PostCon and 44 controls). After MTA, PostCon was performed on the treatment group by applying 4 cycles of alternate reperfusion and reocclusion (60 seconds each) using the angioplasty balloon. The primary end point was infarct size assessed by the area under the curve (AUC) of troponin T (TnT) activity. The secondary end points were left ventricle ejection fraction (LVEF) and major cardiac events (new myocardial infarction or cardiac death) both at discharge and at follow-up. Results: The AUC for TnT was no different with respect to study arms (median [interquartile range]): PostCon = 8.9 (10.6) versus control = 8.2 (10.6), P = .68. Left ventricle ejection fraction improved from in-hospital to follow-up (9 3 months) for the entire cohort (46.3% +/- 7.3% vs 52.2% +/- 10.7%, P < .001), with no differences between PostCon and controls (51.6% +/- 9.5% vs 52.7% +/- 11.9%, P = .89); major cardiac events at 14 +/- 4 months of follow-up were also no different (PostCon = 1.0 (2.3%) vs control = 0, P = .49). Conclusion: In patients with STEMI treated with MTA, PostCon offered no benefits to infarct size, LVEF, or major cardiac events.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9