TY - JOUR
T1 - Long-term effects of ischemic postconditioning on clinical outcomes
T2 - 1-year follow-up of the POST randomized trial
AU - Hahn, Joo Yong
AU - Yu, Cheol Woong
AU - Park, Hun Sik
AU - Song, Young Bin
AU - Kim, Eun Kyoung
AU - Lee, Hyun Jong
AU - Bae, Jang Whan
AU - Chung, Woo Young
AU - Choi, Seung Hyuk
AU - Choi, Jin Ho
AU - Bae, Jang Ho
AU - An, Kyung Joo
AU - Park, Jong Seon
AU - Oh, Ju Hyeon
AU - Kim, Sang Wook
AU - Hwang, Jin Yong
AU - Ryu, Jae Kean
AU - Lim, Do Sun
AU - Gwon, Hyeon Cheol
N1 - Funding Information:
J.Y. Hahn has received research grants from the Korean Society of Interventional Cardiology and the Sungkyunkwan University Foundation for Corporate Collaboration and speaker’s fees from Abbott Vascular, AstraZeneca, Daiichi Sankyo, Lilly, Pfizer, and Sanofi-Aventis. H.C. Gwon has received research grants from Abbott Vascular, Boston Scientific, Biotronik, and Medtronic and speaker’s fees from Abbott Vascular, Boston Scientific, and Medtronic. All other authors declare that they have no conflicts of interest.
Funding Information:
This research was supported by a grant of the Korea Health Technology Research and Development Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no. HI10C2020).
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84929262060&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2015.01.015
DO - 10.1016/j.ahj.2015.01.015
M3 - Article
C2 - 25965711
AN - SCOPUS:84929262060
VL - 169
SP - 639
EP - 646
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 5
ER -