Article Text
Abstract
Objectives To observe the effect of ischaemia postconditioning during the first minutes of reperfusion for the myocardial reperfusion injury in ST segment elevation acute myocardial infarction (STEMl) patients undergoing emergency percutaneous coronary intervention (PCI).
Methods Patients undergoing emergency PCI in affiliated hospital of Inner Mongolia Medical University between October 2006 and October 2010, Were randomly divided into two groups: the control group (n = 40) without any intervention after PCI, and the postconditioning group (n = 50) with ischaemic postconditioning within first 2 minutes of fellow by 3 episodes of 30 seconds inflation and 30 seconds deflation with the angioplasty balloon. Reperfusion arrhythmias, cTnt and CK-MB. corrected TIMI frame count (CTFC), wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) by echocardiography were compared between the two groups. MI areas Were evaluated with the ECT and myocardial blush grade (MBG) was measured.
Results The incidence of reperfusion arrhythmias-frequent ventricular premature (28.1% vs 51.2%, P < 0.01) and short array ventricular tachycardia beat (21.2% vs 52.3%, P < 0.01) as well as values of peaks cTnt[(2.5 ± 0.4) ng/L vs (0.8 ± 0.1) u/L, P < 0.01], CK-MB[(152 ± 70) u/L vs (96 ± 23) u/L, P < 0.01 ]. CTFC(22.23 ± 3.81 vs 26.97 ± 3.42, P < 0.05). WMSI (1.27 ± 0.52 vs 1.82 ± 0.83, P < 0.05), and infarction area determined by ECT (19.2% ± 4.71% vs 13.53% ± 2.78%, P < 0.05) were all significantly higher in the control group than in postconditioning group, while LVEF (0.57 ± 0.02 vs 0.44 ± 0.11, P < 0.05) and MBG (2.52 ± 0.41 vs 1.35 ± 024, P < 0.05)were significantly higher in the postconditioning group than in control group.
Conclusions Ischaemic postconditioning can significantly reduce myocardial reperfusion injury in patients with STEMI.