Long-term effects of ischemic postconditioning on clinical outcomes: 1-year follow-up of the POST randomized trial

Joo Yong Hahn, Cheol Woong Yu, Hun Sik Park, Young Bin Song, Eun Kyoung Kim, Hyun Jong Lee, Jang Whan Bae, Woo Young Chung, Seung Hyuk Choi, Jin Ho Choi, Jang Ho Bae, Kyung Joo An, Jong Seon Park, Ju Hyeon Oh, Sang Wook Kim, Jin Yong Hwang, Jae Kean Ryu, Do-Sun Lim, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)639-646
Number of pages8
JournalAmerican Heart Journal
Volume169
Issue number5
DOIs
Publication statusPublished - 2015 May 1

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Ischemic Postconditioning
Percutaneous Coronary Intervention
Stents
Myocardial Reperfusion
Thrombosis
Heart Failure
Myocardial Infarction
Balloon Occlusion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Long-term effects of ischemic postconditioning on clinical outcomes : 1-year follow-up of the POST randomized trial. / Hahn, Joo Yong; Yu, Cheol Woong; Park, Hun Sik; Song, Young Bin; Kim, Eun Kyoung; Lee, Hyun Jong; Bae, Jang Whan; Chung, Woo Young; Choi, Seung Hyuk; Choi, Jin Ho; Bae, Jang Ho; An, Kyung Joo; Park, Jong Seon; Oh, Ju Hyeon; Kim, Sang Wook; Hwang, Jin Yong; Ryu, Jae Kean; Lim, Do-Sun; Gwon, Hyeon Cheol.

In: American Heart Journal, Vol. 169, No. 5, 01.05.2015, p. 639-646.

Research output: Contribution to journalArticle

Hahn, JY, Yu, CW, Park, HS, Song, YB, Kim, EK, Lee, HJ, Bae, JW, Chung, WY, Choi, SH, Choi, JH, Bae, JH, An, KJ, Park, JS, Oh, JH, Kim, SW, Hwang, JY, Ryu, JK, Lim, D-S & Gwon, HC 2015, 'Long-term effects of ischemic postconditioning on clinical outcomes: 1-year follow-up of the POST randomized trial', American Heart Journal, vol. 169, no. 5, pp. 639-646. https://doi.org/10.1016/j.ahj.2015.01.015
Hahn, Joo Yong ; Yu, Cheol Woong ; Park, Hun Sik ; Song, Young Bin ; Kim, Eun Kyoung ; Lee, Hyun Jong ; Bae, Jang Whan ; Chung, Woo Young ; Choi, Seung Hyuk ; Choi, Jin Ho ; Bae, Jang Ho ; An, Kyung Joo ; Park, Jong Seon ; Oh, Ju Hyeon ; Kim, Sang Wook ; Hwang, Jin Yong ; Ryu, Jae Kean ; Lim, Do-Sun ; Gwon, Hyeon Cheol. / Long-term effects of ischemic postconditioning on clinical outcomes : 1-year follow-up of the POST randomized trial. In: American Heart Journal. 2015 ; Vol. 169, No. 5. pp. 639-646.
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abstract = "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.",
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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

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.

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