Vol. 40 | No. 2 | July-December 2012 Back

Open Access

Reduction of Infarct Size in Patients with Acute ST Elevation Myocardial Infarction by Postconditioning during Percutaneous Coronary Intervention : A Meta Analysis

Edda Mae B. Omambing-Mallillin, Frederick Cheng
Dec 2012 DOI 10.69944/pjc.24a90e014a

Abstract

BACKGROUND: Following an acute coronary artery occlusion, timely myocardial reperfusion by primary percutaneous coronary intervention (PCI) is the recommended therapy, but restoring blood flow can induce reperfusion injury. Myocardial postconditioning (POC), defined as a sequence of intermittent interruptions of coronary blood flow applied at the onset of reperfusion after a period of sustained ischemia, has been shown to attenuate infarct size and reperfusion injury in patients with acute myocardial infarction undergoing PCI. 

METHODS: This is a meta-analysis of the available data from randomized trials on the effects of postconditioning on infarct size, as measured by single-photon emission computed tomography (SPECT) in ST elevation myocardial infarction (STEMI) patients who underwent PCI . 

RESULTS: Four randomized control trial studies were identified, comprising 244 patients with STEMI undergoing PCI with or without postconditioning. No adverse events occurred in the postconditioning group. Pooled analysis of all studies demonstrated a significant reduction in infarct size with postconditioning relative to standard care (standard mean difference -0.82, 95% CI -1.10 to -0.55; p=0.00005) as measured by SPECT. 

CONCLUSION: Postconditioning is a safe and feasible strategy that may reduce the infarct size in patients with STEMI and confer cardioprotection in the clinical setting.

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