Ischemic Postconditioning Before Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction Reduces Contrast-induced Nephropathy and Improves Long-term Prognosis
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- 作者：Yun-yun Wang ; Tong Li ; litong3zx@sina.com ; Ying-wu Liu ; Yu Wang ; Xiao-min Hu ; Wen-qing Gao ; Peng Wu ; Xin Li ; Wen-jin Peng ; Wei Gao ; Guang-dong Yu ; Bo-jiang Liu
- 关键词：Acute myocardial infarction ; Ischemic postconditioning ; Percutaneous coronary intervention ; Contrast-induced nephropathy ; Long term prognosis
- 刊名：Archives of Medical Research
- 出版年：2016
- 出版时间：August 2016
- 年：2016
- 卷：47
- 期：6
- 页码：483-488
- 全文大小：185 K
- 卷排序：47
文摘
Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) is one of the major adverse outcomes affecting the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI). Ischemic postconditioning prior to PCI (pre-PCI) in patients with STEMI is hypothesized to be protective against CIN after PCI.MethodsA total of 251 patients with STEMI were randomized into two groups: ischemic postconditioning group (n = 123, age, 61.1 ± 12.5 years) who underwent ischemic postconditioning prior to PCI; control group (n = 128; age, 64.1 ± 12.1 years) who underwent only PCI. Ischemic postconditioning was administered by three cycles of deflation and inflation of the balloon (1-min ischemia and 1-min reperfusion) starting 1 min after infarct-related artery (IRA) opening. Diagnostic criterion for CIN was: increase in serum creatinine level by ≥0.5 mg/dL or by ≥25% increase from preoperative level within 48 h of surgery. All patients were followed for 1 year for incidence of major cardiovascular events (MACE).ResultsThe incidence of postoperative CIN in the ischemic postconditioning group was 5.69% as compared to 14.06% in the control group (p <0.05). At one year, the MACE incidence in the ischemic postconditioning group was 7.32% as compared to 15.63% in the control group (p <0.05).ConclusionsPre-PCI ischemic postconditioning in STEMI patients significantly reduces the post-PCI incidence of CIN and improves long-term prognosis.