Cardio-protective effect of ischemic post-conditioning in patients with acute myocardial infarction after emergency percutaneous coronary intervention
He Hua
Dong Daoran
Li Nan
Zhu Dan
Zeng Yujie
Abstract：Objective To evaluate the cardio-protective effect of ischemic post-conditioning (IPOC) in patients with acute myocardial infarction after emergency percutaneous coronary intervention (PCI).Methods Two hundred and sixteen patients with acute myocardial infarction who received emergency PCI were randomly divided into IPOC group (114 cases) and the control group (102 cases).Three times of balloon inflation (4 kPa,30 s) and deflation (30 s) of the stent were performed in the related artery within 1 min after stent implantation in IPOC group;no interventions were given after stent implantation in control group.The recovery of ST-segment,the peak levels of creatine kinase (CK),creatine kinase-MB (CK-MB),cardiac Troponin I (c-TNI),the echocardiographic parameters including left ventricular end-diastolic volume index (LVEDVI),left ventricular end-systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) after operation were measured and compared between the two groups.In addition,the incidences of reperfusion arrhythmias,the myocardial perfusion and thrombolysis in myocardial infarction (TIMI) flow grade were observed.Results There were 55,68,73 cases with complete recovery of ST-segment in IPOC group and 45,54,61 cases in control group at 2,4 and 6 h after operation (P ＜ 0.05).The peak levels of CK,CK-MB and c-TnⅠ in IPOC group were significantly lower than those in control group [(1 418 ±634) U/L vs (2 324 ± 862) U/L,(121 ± 113) mmol/L vs (188 ± 147) mmol/L,(17 ± 12) mmol/L vs (21 ± 10) mmol/L,respectively,P ＜ 0.05].The incidences of reperfusion arrhythmias during and after operation in IPOC group were decreased obviously compared with those in control group [22.8％(26/114) vs41.2％ (42/102),5.3％ (6/114)vs21.6％ (22/102),P＜0.05].In IPOC group,there were 5 cases of myocardial Blush grading 0-1,21 cases of Blush grading 2 and 88 cases of Blush grading 3,significantly different from those in control group [6 cases of Blush grading 0-1,33 cases of Blush grading 2 and 63 cases of Blush grading 3] (P ＜ 0.05).The LVESVI,LVEDSI,LVEF and TIMI flow grade 24 h and 1 week after operation showed no significant difference between two groups (P ＞ 0.05).Conclusion IPOC has cardioprotective effect in patients with acute myocardial infarction after PCI,which can reduce the infarct size,decrease the incidence of reperfusion arrhythmias and improve the microcirculation in myocardium.
Keywords：Acute myocardial infarctionPercutaneous coronary interventionIschemic postconditioningIschemia reperfusion injury
Publication Date：2015-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 777-781 )