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Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial

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Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial. / Engstrøm, Thomas; Kelbæk, Henning; Helqvist, Steffen; Høfsten, Dan Eik; Kløvgaard, Lene; Clemmensen, Peter; Holmvang, Lene; Jørgensen, Erik; Pedersen, Frants; Saunamaki, Kari; Ravkilde, Jan; Tilsted, Hans-Henrik; Villadsen, Anton; Aarøe, Jens; Jensen, Svend Eggert; Raungaard, Bent; Bøtker, Hans E; Terkelsen, Christian J; Maeng, Michael; Kaltoft, Anne; Krusell, Lars R; Jensen, Lisette O; Veien, Karsten T; Kofoed, Klaus Fuglsang; Torp-Pedersen, Christian; Kyhl, Kasper; Nepper-Christensen, Lars; Treiman, Marek; Vejlstrup, Niels; Ahtarovski, Kiril; Lønborg, Jacob; Køber, Lars; Third Danish Study of Optimal Acute Treatment of Patients With ST Elevation Myocardial Infarction–Ischemic Postconditioning (DANAMI-3–iPOST) Investigators.

In: JAMA CARDIOL, Vol. 2, No. 5, 01.05.2017, p. 490-497.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Engstrøm, T, Kelbæk, H, Helqvist, S, Høfsten, DE, Kløvgaard, L, Clemmensen, P, Holmvang, L, Jørgensen, E, Pedersen, F, Saunamaki, K, Ravkilde, J, Tilsted, H-H, Villadsen, A, Aarøe, J, Jensen, SE, Raungaard, B, Bøtker, HE, Terkelsen, CJ, Maeng, M, Kaltoft, A, Krusell, LR, Jensen, LO, Veien, KT, Kofoed, KF, Torp-Pedersen, C, Kyhl, K, Nepper-Christensen, L, Treiman, M, Vejlstrup, N, Ahtarovski, K, Lønborg, J, Køber, L & Third Danish Study of Optimal Acute Treatment of Patients With ST Elevation Myocardial Infarction–Ischemic Postconditioning (DANAMI-3–iPOST) Investigators 2017, 'Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial', JAMA CARDIOL, vol. 2, no. 5, pp. 490-497. https://doi.org/10.1001/jamacardio.2017.0022

APA

Engstrøm, T., Kelbæk, H., Helqvist, S., Høfsten, D. E., Kløvgaard, L., Clemmensen, P., Holmvang, L., Jørgensen, E., Pedersen, F., Saunamaki, K., Ravkilde, J., Tilsted, H-H., Villadsen, A., Aarøe, J., Jensen, S. E., Raungaard, B., Bøtker, H. E., Terkelsen, C. J., Maeng, M., ... Third Danish Study of Optimal Acute Treatment of Patients With ST Elevation Myocardial Infarction–Ischemic Postconditioning (DANAMI-3–iPOST) Investigators (2017). Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial. JAMA CARDIOL, 2(5), 490-497. https://doi.org/10.1001/jamacardio.2017.0022

Vancouver

Engstrøm T, Kelbæk H, Helqvist S, Høfsten DE, Kløvgaard L, Clemmensen P et al. Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial. JAMA CARDIOL. 2017 May 1;2(5):490-497. https://doi.org/10.1001/jamacardio.2017.0022

Bibtex

@article{621adff83a824b8fb809800143a7ceb6,
title = "Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial",
abstract = "Importance: Ischemic postconditioning of the heart during primary percutaneous coronary intervention (PCI) induced by repetitive interruptions of blood flow to the ischemic myocardial region immediately after reopening of the infarct-related artery may limit myocardial damage.Objective: To determine whether ischemic postconditioning can improve the clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI).Design, Setting, And Participants: In this multicenter, randomized clinical trial, patients with onset of symptoms within 12 hours, STEMI, and thrombolysis in myocardial infarction (TIMI) grade 0-1 flow in the infarct-related artery at arrival were randomized to conventional PCI or postconditioning. Inclusion began on March 21, 2011, through February 2, 2014, and follow-up was completed on February 2, 2016. Analysis was based on intention to treat.Interventions: Patients were randomly allocated 1:1 to conventional primary PCI, including stent implantation, or postconditioning performed as 4 repeated 30-second balloon occlusions followed by 30 seconds of reperfusion immediately after opening of the infarct-related artery and before stent implantation.Main Outcome and Measures: A combination of all-cause death and hospitalization for heart failure.Results: During the inclusion period, 1234 patients (975 men [79.0%] and 259 women [21.0%]; mean [SD] age, 62 [11] years) underwent randomization in the trial. Median follow-up was 38 months (interquartile range, 24-58 months). The primary outcome occurred in 69 patients (11.2%) who underwent conventional primary PCI and in 65 (10.5%) who underwent postconditioning (hazard ratio, 0.93; 95% CI, 0.66-1.30; P = .66). The hazard ratios were 0.75 (95% CI, 0.49-1.14; P = .18) for all-cause death and 0.99 (95% CI, 0.60-1.64; P = .96) for heart failure.Conclusions and Relevance: Routine ischemic postconditioning during primary PCI failed to reduce the composite outcome of death from any cause and hospitalization for heart failure in patients with STEMI and TIMI grade 0-1 flow at arrival.Trial Registration: clinicaltrials.gov Identifier: NCT01435408.",
keywords = "Aged, Cause of Death, Coronary Vessels, Denmark, Female, Heart Failure/epidemiology, Hospitalization/statistics & numerical data, Humans, Ischemic Postconditioning/methods, Male, Middle Aged, Mortality, Myocardium, Percutaneous Coronary Intervention/methods, Proportional Hazards Models, ST Elevation Myocardial Infarction/therapy, Stents, Treatment Outcome",
author = "Thomas Engstr{\o}m and Henning Kelb{\ae}k and Steffen Helqvist and H{\o}fsten, {Dan Eik} and Lene Kl{\o}vgaard and Peter Clemmensen and Lene Holmvang and Erik J{\o}rgensen and Frants Pedersen and Kari Saunamaki and Jan Ravkilde and Hans-Henrik Tilsted and Anton Villadsen and Jens Aar{\o}e and Jensen, {Svend Eggert} and Bent Raungaard and B{\o}tker, {Hans E} and Terkelsen, {Christian J} and Michael Maeng and Anne Kaltoft and Krusell, {Lars R} and Jensen, {Lisette O} and Veien, {Karsten T} and Kofoed, {Klaus Fuglsang} and Christian Torp-Pedersen and Kasper Kyhl and Lars Nepper-Christensen and Marek Treiman and Niels Vejlstrup and Kiril Ahtarovski and Jacob L{\o}nborg and Lars K{\o}ber and {Third Danish Study of Optimal Acute Treatment of Patients With ST Elevation Myocardial Infarction–Ischemic Postconditioning (DANAMI-3–iPOST) Investigators}",
year = "2017",
month = may,
day = "1",
doi = "10.1001/jamacardio.2017.0022",
language = "English",
volume = "2",
pages = "490--497",
journal = "JAMA CARDIOL",
issn = "2380-6583",
publisher = "American Medical Association",
number = "5",

}

RIS

TY - JOUR

T1 - Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial

AU - Engstrøm, Thomas

AU - Kelbæk, Henning

AU - Helqvist, Steffen

AU - Høfsten, Dan Eik

AU - Kløvgaard, Lene

AU - Clemmensen, Peter

AU - Holmvang, Lene

AU - Jørgensen, Erik

AU - Pedersen, Frants

AU - Saunamaki, Kari

AU - Ravkilde, Jan

AU - Tilsted, Hans-Henrik

AU - Villadsen, Anton

AU - Aarøe, Jens

AU - Jensen, Svend Eggert

AU - Raungaard, Bent

AU - Bøtker, Hans E

AU - Terkelsen, Christian J

AU - Maeng, Michael

AU - Kaltoft, Anne

AU - Krusell, Lars R

AU - Jensen, Lisette O

AU - Veien, Karsten T

AU - Kofoed, Klaus Fuglsang

AU - Torp-Pedersen, Christian

AU - Kyhl, Kasper

AU - Nepper-Christensen, Lars

AU - Treiman, Marek

AU - Vejlstrup, Niels

AU - Ahtarovski, Kiril

AU - Lønborg, Jacob

AU - Køber, Lars

AU - Third Danish Study of Optimal Acute Treatment of Patients With ST Elevation Myocardial Infarction–Ischemic Postconditioning (DANAMI-3–iPOST) Investigators

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Importance: Ischemic postconditioning of the heart during primary percutaneous coronary intervention (PCI) induced by repetitive interruptions of blood flow to the ischemic myocardial region immediately after reopening of the infarct-related artery may limit myocardial damage.Objective: To determine whether ischemic postconditioning can improve the clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI).Design, Setting, And Participants: In this multicenter, randomized clinical trial, patients with onset of symptoms within 12 hours, STEMI, and thrombolysis in myocardial infarction (TIMI) grade 0-1 flow in the infarct-related artery at arrival were randomized to conventional PCI or postconditioning. Inclusion began on March 21, 2011, through February 2, 2014, and follow-up was completed on February 2, 2016. Analysis was based on intention to treat.Interventions: Patients were randomly allocated 1:1 to conventional primary PCI, including stent implantation, or postconditioning performed as 4 repeated 30-second balloon occlusions followed by 30 seconds of reperfusion immediately after opening of the infarct-related artery and before stent implantation.Main Outcome and Measures: A combination of all-cause death and hospitalization for heart failure.Results: During the inclusion period, 1234 patients (975 men [79.0%] and 259 women [21.0%]; mean [SD] age, 62 [11] years) underwent randomization in the trial. Median follow-up was 38 months (interquartile range, 24-58 months). The primary outcome occurred in 69 patients (11.2%) who underwent conventional primary PCI and in 65 (10.5%) who underwent postconditioning (hazard ratio, 0.93; 95% CI, 0.66-1.30; P = .66). The hazard ratios were 0.75 (95% CI, 0.49-1.14; P = .18) for all-cause death and 0.99 (95% CI, 0.60-1.64; P = .96) for heart failure.Conclusions and Relevance: Routine ischemic postconditioning during primary PCI failed to reduce the composite outcome of death from any cause and hospitalization for heart failure in patients with STEMI and TIMI grade 0-1 flow at arrival.Trial Registration: clinicaltrials.gov Identifier: NCT01435408.

AB - Importance: Ischemic postconditioning of the heart during primary percutaneous coronary intervention (PCI) induced by repetitive interruptions of blood flow to the ischemic myocardial region immediately after reopening of the infarct-related artery may limit myocardial damage.Objective: To determine whether ischemic postconditioning can improve the clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI).Design, Setting, And Participants: In this multicenter, randomized clinical trial, patients with onset of symptoms within 12 hours, STEMI, and thrombolysis in myocardial infarction (TIMI) grade 0-1 flow in the infarct-related artery at arrival were randomized to conventional PCI or postconditioning. Inclusion began on March 21, 2011, through February 2, 2014, and follow-up was completed on February 2, 2016. Analysis was based on intention to treat.Interventions: Patients were randomly allocated 1:1 to conventional primary PCI, including stent implantation, or postconditioning performed as 4 repeated 30-second balloon occlusions followed by 30 seconds of reperfusion immediately after opening of the infarct-related artery and before stent implantation.Main Outcome and Measures: A combination of all-cause death and hospitalization for heart failure.Results: During the inclusion period, 1234 patients (975 men [79.0%] and 259 women [21.0%]; mean [SD] age, 62 [11] years) underwent randomization in the trial. Median follow-up was 38 months (interquartile range, 24-58 months). The primary outcome occurred in 69 patients (11.2%) who underwent conventional primary PCI and in 65 (10.5%) who underwent postconditioning (hazard ratio, 0.93; 95% CI, 0.66-1.30; P = .66). The hazard ratios were 0.75 (95% CI, 0.49-1.14; P = .18) for all-cause death and 0.99 (95% CI, 0.60-1.64; P = .96) for heart failure.Conclusions and Relevance: Routine ischemic postconditioning during primary PCI failed to reduce the composite outcome of death from any cause and hospitalization for heart failure in patients with STEMI and TIMI grade 0-1 flow at arrival.Trial Registration: clinicaltrials.gov Identifier: NCT01435408.

KW - Aged

KW - Cause of Death

KW - Coronary Vessels

KW - Denmark

KW - Female

KW - Heart Failure/epidemiology

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Ischemic Postconditioning/methods

KW - Male

KW - Middle Aged

KW - Mortality

KW - Myocardium

KW - Percutaneous Coronary Intervention/methods

KW - Proportional Hazards Models

KW - ST Elevation Myocardial Infarction/therapy

KW - Stents

KW - Treatment Outcome

U2 - 10.1001/jamacardio.2017.0022

DO - 10.1001/jamacardio.2017.0022

M3 - SCORING: Journal article

C2 - 28249094

VL - 2

SP - 490

EP - 497

JO - JAMA CARDIOL

JF - JAMA CARDIOL

SN - 2380-6583

IS - 5

ER -