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To evaluate the protective effect of IPC on the myocardial microcirculation response through IMR and the predictive value of IMR on the degree of myocardial reperfusion and the prognosis of patients.
This study is a clinical randomized controlled study, applying index of microcirculatory resistance (IMR) to evaluate the myocardial protection of ischemic postconditioning (IPC) in patients receiving direct PCI treatment for acute myocardial infarction.IMR is a quantitative evaluation index of microcirculation status. IPC has been reported to reduce ischemia-reperfusion injury and has a myocardial protective effect.The research plan divides patients into IPC and non-IPC groups at random. After the infarction-related artery is successfully implanted with a stent, the pressure guide wire is used to measure IMR and CFR in the state of maximal expansion of the microcirculation induced by intravenous ATP infusion.And analyze whether there are differences in indicators between the two groups and the relationship between these indicators and the patient's myocardial level reperfusion, cardiac function and prognosis.The purpose is to evaluate the myocardial protection of IPC and the predictive value of IMR on the degree of myocardial reperfusion and the prognosis of patients. It is expected that the target IPC can improve the IMR value, and IMR can predict the degree of myocardial reperfusion and cardiac function and prognosis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ischemic postconditioning | Experimental | Routine PCI operations (including thrombus aspiration, stent injection, application of GPIIb/IIIa, etc.) + immediate post-ischemic adaptation: 30 seconds balloon inflation and 30 seconds deflation for 3 cycles |
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| No Ischemic postconditioning | Active Comparator | Routine PCI operations (including thrombus aspiration, stent injection, application of GPIIb/IIIa, etc.) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IPC+PCI | Procedure | Routine PCI operations (including thrombus aspiration, stent injection, application of GPIIb/IIIa, etc.) + immediate post-ischemic adaptation: 30 seconds balloon inflation and 30 seconds deflation for 3 cycles |
| Measure | Description | Time Frame |
|---|---|---|
| IMR | index of microcirculatory resistance measured during coronary intervention. | detected immediately after percutaneous coronary intervention |
| Measure | Description | Time Frame |
|---|---|---|
| MACEs after PCI | MACEs includes cardiogenic death, non-fatal myocardial infarction, malignant arrhythmia, unplanned revascularization, unstable angina pectoris requiring hospitalization and severe heart failure requiring hospitalization | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lijun Lijun | Peking University Third Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University third hospital | Beijing | Beijing Municipality | 100089 | China |
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| ID | Term |
|---|---|
| D057775 | Ischemic Postconditioning |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| No IPC | Procedure | Routine PCI operations (including thrombus aspiration, stent injection, application of GPIIb/IIIa, etc. |
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