Postconditioning in the Treatment of Acute ST-segment Elevation Myocardial Infarction

Postconditioning Used to Limit Final Infarct Size in Patients With Acute ST-segment Elevation Myocardial Infarction

Standard treatment of patients with acute ST-segment elevation myocardial infarction consist of acute re-opening of the occluded coronary artery (primary PCI). Despite successful treatment of the epicardial vessel reperfusion is sometimes inadequate leading to large final infarct sizes. This phenomenon is known as the reperfusion injury. Several animal studies have indicated that graded re-opening of the artery may limit tissue damage. Generally this is referred to as mechanical postconditioning.

The study investigates the effect on final infarct size evaluated by magnetic resonance scan of postconditioning of ST-segment elevation myocardial infarctions. Mechanical postconditioning is performed by means of several balloon inflations in the injured vessel following its acute re-opening.

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Inclusion Criteria:

• Patients more than 18 years
• STEMI < 12 hours
• TIMI 0-1 in infarct related artery

Exclusion Criteria:

• Multivessel disease (stenoses in non-infarct related arteries >70%)
• Cardiogenic shock
• Left main occlusions
• Lesions that cannot be treated with stents
• Previous CABG
• Pregnancy
• Severe renal insufficiency
• Previous extensive Q-wave infarction
• LBBB