Preventive effect of ischemic postconditioning on non-culprit lesion progression in patients with acute myocardial infarction after primary percutaneous coronary intervention
Wang Jian
Huang Yansheng
Wei Jinghan
Liu Jinghua
Wang Shaoping
Zhang Ming
Zheng Bin
Wang Changhua
Abstract：Objective To investigate the preventive effect of ischemic postconditioning on non-culprit lesion progression in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention(PCI).Methods A total of 200 STEMI patients undergoing primary PCI from January 2010 to December 2013 in Beijing Anzhen Hospital,Capital Medical University were randomly divided into ischemic postconditioning group and eontrol group,with 100 cases in each group.Postoperative recovery,non-culprit lesion progression and related clinical indicators were analyzed.Results Secondary PCI rate of non-culprit lesion in 12 months after operation in ischemic postconditioning group was significantly lower than that in control group [7.0％ (7/100) vs 21.0％ (21/100)] (P ＜0.01).Seventy-nine patients did not have reoperation(group A) and 21 patients had secondary PCI (group B) in control group;93 patients did not have reoperation (group C) and 7 patients had secondary PCI (group D) in ischemic postconditioning group.Serum levels of adrenaline and noradrenaline in group B were significantly higher than those in group A;levels of adrenaline and noradrenaline in group D were significantly higher than those in group C(P ＜0.001).Types of non-culprit lesion showed no significant difference among group A,B,C and D (P ＞ 0.05).Serum levels of adrenaline,noradrenaline and C-reactive protein in patients without reoperation(n =172) were significantly lower than those in patients with secondary PCI (n =28) [(223 ± 48) ng/L vs (309 ± 52) ng/L,(1 807 ± 365) ng/L vs (2 528 ± 421) ng/L,(18 ± 6) mg/L vs (24± 8)mg/L] (P ＜0.001).Conclusions Revascularization after primary PCI is related to non-culprit lesion progression in patients with STEMI.Ischemic postconditioning may prevent non-culprit artery lesion progression.
Keywords：ST-segment elevation myocardial infarctionNon-culprit lesionPercutaneous coronary interventionIschemic postconditioning
Publication Date：2018-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 805-809 )