Delayed Postconditioning

Hospices Civils de Lyon72 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Myocardial Reperfusion Injury

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patient \> 18 years old * Male or female * Presenting first myocardial infarction, with the beginning of pains \< 12 hours, * Requiring a revascularisation by primary angioplasty or " rescue " (after failure of thrombolysis) on LAD or RCA (not Circumflex coronary artery). * TIMI flow grade at admission of 2 or 3 * LV angiography (RAO30°) before angioplasty. Exclusion Criteria: * Cardiac arrest before the angioplasty * Cardiogenic shock * Occlusion of the artery circumflex responsible for the infarction * Visible collaterals to the area at risk * Magnetic resonance imaging: contra indication

Locations (5)

Service de Cardiologie, CHU d'Angers

Angers, France

Service d'explorations Fonctionnelles Cardiovasculaires, Hôpital Cardiologique Louis Pradel

Bron, France

Service de Cardiologie, Hôpital Arnaud de Villeneuve

Montpellier, France

Service de Cardiologie, Hôpital Emile Müller

Mulhouse, France

Service de Cardiologie, Hôpital Rangueil

Toulouse, France

Outcomes

Primary Outcomes

Size of the infarct

Size of the infarct estimated by magnetic resonance imaging at day 5 post-reperfusion

Time frame: Day 5 post reperfusion

Secondary Outcomes

Contractile functional recovery

Contractile functional recovery estimated by echocardiography at 6th month versus before discharge.

Time frame: 6 months after reperfusion