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

Title
Long-term effects of ischemic postconditioning on clinical outcomes: 1-year follow-up of the POST randomized trial
Author(s)
박종선한주용[한주용]유철웅[유철웅]박헌식[박헌식]송영빈[송영빈]김은경[김은경]이현종[이현종]배장환[배장환]정우영[정우영]최승혁[최승혁]최진호[최진호]배장호[배장호]안경주[안경주]오주현[오주현]김상욱[김상욱]황진용[황진용]류재근[류재근]임도선[임도선]권현철[권현철]
Keywords
PERCUTANEOUS CORONARY INTERVENTION; ELEVATION MYOCARDIAL-INFARCTION; ST-SEGMENT ELEVATION; MAGNETIC-RESONANCE; REPERFUSION INJURY; HUMAN HEART; SIZE; INHIBITION; ASPIRATION; RESOLUTION
Issue Date
201505
Publisher
MOSBY-ELSEVIER
Citation
AMERICAN HEART JOURNAL, v.169, no.5, pp.639 - 646
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.
URI
http://hdl.handle.net/YU.REPOSITORY/32299http://dx.doi.org/10.1016/j.ahj.2015.01.015
ISSN
0002-8703
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의과대학 > 내과학교실 > Articles
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