Postconditioning during coronary angioplasty in acute myocardial infarction: the POST-AMI trial

Tarantini, Giuseppe; Favaretto, Enrico; Marra, Martina Perazzolo; Frigo, Anna Chiara; Napodano, Massimo; Cacciavillani, Luisa; Giovagnoni, Andrea; Renda, Pietro; Biasio, Valeria De; Plebani, Mario; Mion, Monica; Zaninotto, Martina; Isabella, Giambattista; Bilato, Claudio; Iliceto, Sabino

doi:10.1016/j.ijcard.2012.03.136

Cited by 111 publications

(111 citation statements)

References 30 publications

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“…9 Notably, postconditioning showed harmful effects in 2 other studies. 10,11 The contradictory findings in previous studies may be attributable to differences in PCI procedures. Studies in which only direct stenting was allowed or was predominantly performed demonstrated the beneficial effects of ischemic postconditioning, 5,8,12 whereas studies in which primary PCI was performed according to current standard practice such as predilation or thrombus aspiration failed to demonstrate the beneficial effects of ischemic postconditioning.…”

Section: Discussionmentioning

confidence: 97%

“…[5][6][7] However, the results of studies using magnetic resonance imaging to evaluate the effects of postconditioning on infarct size were inconsistent. [8][9][10][11][12] Moreover, most studies have not reflected current practice patterns such as thrombus aspiration, predilation before stenting, or use of glycoprotein IIb/IIIa inhibitors. Until now, cardioprotective effects of ischemic postconditioning have not been demonstrated in a large-scale trial.…”

Section: October 22 2013mentioning

confidence: 99%

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Ischemic Postconditioning During Primary Percutaneous Coronary Intervention

et al. 2013

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Section: Discussionmentioning

confidence: 97%

Section: October 22 2013mentioning

confidence: 99%

Ischemic Postconditioning During Primary Percutaneous Coronary Intervention

et al. 2013

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“…163 However, neither the reduction of infarct size nor a reduction of microvascular obstruction was confirmed in other trials. [165][166][167][168][169][170] Reasons for such discrepancy are not really clear but may relate to use of direct stenting or lack of it 48,171 and the increasing use of P2Y 12 antagonists which induce cardioprotection per se such that the potential for further protection is diminished.…”

Section: Coronary Vascular Protection By Ischemic Postconditioningmentioning

confidence: 99%

The Coronary Circulation as a Target of Cardioprotection

Heusch

2016

Circulation Research

209

160

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Abstract:The atherosclerotic coronary vasculature is not only the culprit but also a victim of myocardial ischemia/ reperfusion injury. Manifestations of such injury are increased vascular permeability and edema, endothelial dysfunction and impaired vasomotion, microembolization of atherothrombotic debris, stasis with intravascular cell aggregates, and finally, in its most severe form, capillary destruction with hemorrhage. In animal experiments, local and remote ischemic pre-and postconditioning not only reduce infarct size but also these manifestations of coronary vascular injury, as do drugs which recruit signal transduction steps of conditioning. Clinically, no-reflow is frequently seen after interventional reperfusion, and it carries an adverse prognosis. The translation of cardioprotective interventions to clinical practice has been difficult to date. Only 4 drugs (brain natriuretic peptide, exenatide, metoprolol, and esmolol) stand unchallenged to date in reducing infarct size in patients with reperfused acute myocardial infarction; unfortunately, for these drugs, no information on their impact on the ischemic/reperfused coronary circulation is available. (Circ Res.

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“…Further, patients with larger infarcts or those with an anterior MI are more likely to benefit from such an intervention. 5,6,27,32 Indeed, in our initial study, there was a trend toward a stronger effect of sevoflurane in patients with an anterior MI on assessing myocardial injury by release of cardiac enzymes. 20 In the current study, we did not observe an overall clinically meaningful effect of sevoflurane on the long-term assessment of LV function, myocardial scarring, or hibernating myocardium.…”

Section: Discussionmentioning

confidence: 78%

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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Background Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. Methods In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient's arrival for cardiac catheterization, the anesthesia team administered sevoflurane or oxygen for 30 min using a tight-fitting mask.In this substudy, we report the one-year outcomes. Patients were followed clinically for one year; they underwent a thallium cardiac viability study at six months and an echocardiogram at one year. Results Forty-six patients completed follow-up. One patient in the sevoflurane group died. The mean [standard deviation (SD)] ejection fraction by singlephoton emission computed tomography at six months was 51.7 (7.7)% in the sevoflurane group and 51 (9.1)% in the control group (mean difference, 0.7%; 95% confidence interval [CI], -5.9 to 7.3; P = 0.831). The median [interquartile range] amount of scarring at six months was 0% [0 -8] in the sevoflurane group and 2.5% [0 -7.1] in control group (mean difference, -0.1%; 95% CI, -4.6 to 4.4; P = 0.700). The mean (SD) percentage of hibernating myocardium was similar in both groups 0% [0, 5] (mean difference, -1.3%; 95% CI, -3.4 to 0.9; P = 0.259). The mean (SD) ejection fraction at one year increased compared with baseline by 8.0 (9.1)% (P \ 0.001).Conclusions In this study, we did not find an effect of sevoflurane on left ventricular function or myocardial injury at one year post STEMI. This trial was registered at www.clinicaltrials.gov; identifier: NCT00971607. RésuméContexte Le sévoflurane est un anesthésique inhalé qui a des effets cardioprotecteurs. On ne dispose que de peu Meeting presentation: Presented in part at the Canadian Cardiovascular Congress in Vancouver, 2014 and published as an abstract (Can J Cardiol 2014, 30 (10): s62.).

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Postconditioning during coronary angioplasty in acute myocardial infarction: the POST-AMI trial

Cited by 111 publications

References 30 publications

Ischemic Postconditioning During Primary Percutaneous Coronary Intervention

Ischemic Postconditioning During Primary Percutaneous Coronary Intervention

The Coronary Circulation as a Target of Cardioprotection

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

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