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The investigators previously reported that angioplasty postconditioning reduces infarct size (cardiac enzyme release) in STEMI patients with a fully occluded coronary artery at hospital admission. Animal studies have suggested that the time window for applying brief episodes of ischemia and reperfusion aimed at triggering postconditioning's protection is very narrow, i.e. does not expand beyond 1 minute after reflow. We sought to address whether this window might be larger in humans, i.e. whether STEMI patients might be protected several minutes after undergoing spontaneous reperfusion before admission coronary angiography.
Therefore, STEMI patients (onset of chest pain less than 12 hours) with a TIMI flow grade > 1 were eligible for that study. Angioplasty postconditioning was completed as already published and infarct size was assessed by measuring cardiac enzymes release.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Postconditionned | Experimental | 36 postconditionned patients |
|
| Conventional intervention | Sham Comparator | 36 control patients with conventional primary percutaneaous intervention (PCI) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Postconditioning | Procedure | Postconditioning consists of four cycles of one minute balloon inflation followed by one minute of balloon deflation, with the initial inflation being started within the first minute after reopening of the culprit coronary artery. |
| Measure | Description | Time Frame |
|---|---|---|
| Size of the infarct | Size of the infarct estimated by magnetic resonance imaging at day 5 post-reperfusion | Day 5 post reperfusion |
| Measure | Description | Time Frame |
|---|---|---|
| Contractile functional recovery | Contractile functional recovery estimated by echocardiography at 6th month versus before discharge. | 6 months after reperfusion |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service de Cardiologie, CHU d'Angers | Angers | 49933 | France | |||
| Service d'explorations Fonctionnelles Cardiovasculaires, Hôpital Cardiologique Louis Pradel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24585265 | Result | Roubille F, Mewton N, Elbaz M, Roth O, Prunier F, Cung TT, Piot C, Roncalli J, Rioufol G, Bonnefoy-Cudraz E, Wiedemann JY, Furber A, Jacquemin L, Willoteaux S, Abi-Khallil W, Sanchez I, Finet G, Sibellas F, Ranc S, Boussaha I, Croisille P, Ovize M. No post-conditioning in the human heart with thrombolysis in myocardial infarction flow 2-3 on admission. Eur Heart J. 2014 Jul 1;35(25):1675-82. doi: 10.1093/eurheartj/ehu054. Epub 2014 Feb 28. |
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| ID | Term |
|---|---|
| D015428 | Myocardial Reperfusion Injury |
| D009203 | Myocardial Infarction |
| ID | Term |
|---|---|
| D009202 | Cardiomyopathies |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D017202 | Myocardial Ischemia |
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| ID | Term |
|---|---|
| D057775 | Ischemic Postconditioning |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| Percutaneaous intervention | Procedure | Conventional primary percutaneaous intervention |
|
| Bron |
| 69677 |
| France |
| Service de Cardiologie, Hôpital Arnaud de Villeneuve | Montpellier | 34295 | France |
| Service de Cardiologie, Hôpital Emile Müller | Mulhouse | 68051 | France |
| Service de Cardiologie, Hôpital Rangueil | Toulouse | 31059 | France |
| D014652 |
| Vascular Diseases |
| D015427 | Reperfusion Injury |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007238 | Infarction |
| D007511 | Ischemia |
| D009336 | Necrosis |