| 'Postconditioning' the human heart: multiple balloon inflations during primary angioplasty may confer cardioprotection. | |
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MedLine Citation:
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PMID: 17235447 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Growing evidence from experimental models suggests that relief of myocardial ischemia in a stuttering manner (i.e., 'postconditioning' [PostC] with brief cycles of reperfusion-reocclusion) limits infarct size. However, the potential clinical efficacy of PostC has, to date,been largely unexplored. Using a retrospective study design, our aim was to test the hypothesis that creatine kinase release (CK: clinical surrogate of infarct size) would be attenuated in ST-segment elevation myocardial infarction (STEMI) patients requiring multiple balloon inflations-deflations during primary angioplasty versus STEMI patients who received minimal balloon inflations and/or direct stenting. To investigate this concept, we reviewed the records of all STEMI patients with single vessel occlusion who presented to our institution from November 2004 - April 2006 for primary angioplasty. Exclusion criteria were: previous MI, cardiogenic shock, patients resuscitated from cardiac arrest, or pre-infarct angina. Patients were prospectively divided into two subsets: those receiving 1-3 balloon inflations (considered the minimum range to achieve patency and stent placement) versus those in whom 4 or more inflations were applied. Peak CK release was significantly lower in patients requiring > or =4 versus 1-3 inflations (1655 versus 2272 IU/L; p<0.05), an outcome consistent with the concept that relief of sustained ischemia in a stuttered manner (analogous to postconditioning) may evoke cardioprotection in the clinical setting. |
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Authors:
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Chad E Darling; Patrick B Solari; Craig S Smith; Mark I Furman; Karin Przyklenk |
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Publication Detail:
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Type: Journal Article Date: 2007-01-23 |
Journal Detail:
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Title: Basic research in cardiology Volume: 102 ISSN: 0300-8428 ISO Abbreviation: Basic Res. Cardiol. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-06 Completed Date: 2007-11-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0360342 Medline TA: Basic Res Cardiol Country: Germany |
Other Details:
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Languages: eng Pagination: 274-8 Citation Subset: IM |
Affiliation:
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Dept. of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue, North Worcester , MA, 01655, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary
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methods* Creatine Kinase / blood Electrocardiography Female Heart Conduction System Humans Ischemic Preconditioning, Myocardial / methods* Male Middle Aged Myocardial Infarction / blood, therapy* Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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