Comparison of Effect of Ischemic Postconditioning on Cardiovascular Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention With Versus Without Thrombectomy

Madsen, Jasmine Melissa; Glinge, Charlotte; Jabbari, Reza; Nepper‐Christensen, Lars; Høfsten, Dan Eik; Tilsted, Hans‐Henrik; Holmvang, Lene; Pedersen, Frants; Joshi, Francis R.; Sørensen, Rikke; Bang, Lia E.; Bøtker, Hans Erik; Terkelsen, Christian Juhl; Mæng, Michael; Jensen, Lisette Okkels; Aarøe, Jens; Kelbæk, Henning; Torp‐Pedersen, Christian; Køber, Lars; Lønborg, Jacob; Engstrøm, Thomas

doi:10.1016/j.amjcard.2021.11.014

Cited by 8 publications

(3 citation statements)

References 22 publications

(23 reference statements)

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“…In the DANAMI-3-iPOST post-hoc study, ischemic postconditioning in addition to primary PCI was shown to be associated with a reduced risk of all-cause mortality and heart failure-related hospitalization in patients with STEMI who did not undergo thrombectomy. 22,23) Additionally, studies have shown that iPoC was not effective in myocardial infarct size reduction in patients with TIMI 2-3 blood flow, suggesting that patients who benefit the most from iPoC are those with completely occluded coronary arteries. 24) Furthermore, animal studies showed that the mechanism of myocardial protection by iPoC was similar to that of preconditioning, 25) suggesting that the effect of iPoC may be attenuated in patients with PA.…”

Section: Discussionmentioning

confidence: 99%

Potential Effects of Ischemic Postconditioning and Changes in Heat Shock Protein 72 in Patients with Acute Myocardial Infarction without Prodromal Angina

Takeuchi,

Kitani,

Minoshima

et al. 2024

Int. Heart J.

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The effectiveness of ischemic postconditioning (iPoC) in patients with ST-elevation myocardial infarction (STEMI) without ischemic preconditioning has not been determined. Therefore, we investigated the impact of iPoC and its potential mechanism related to heat shock protein 72 (HSP72) induction on myocardial salvage in patients with STEMI without prodromal angina (PA).We retrospectively analyzed data from 102 patients with STEMI with successful reperfusion among 323 consecutive patients with acute coronary syndrome. Among these, 55 patients with iPoC (iPoC(+)) underwent 4 cycles of 60-second inflation and 30-second deflation of the angioplasty balloon. Both the iPoC(+) and iPoC(-) groups were divided into 2 further subgroups: patients with PA (PA(+)) and those without (PA(-)). We analyzed HSP72 levels in neutrophils, which were measured until 48 hours after reperfusion. I-123 β-methyl-piodophenyl-pentadecanoic acid (BMIPP) scintigraphy was performed within a week of reperfusion therapy. In 64% of patients, thallium-201 (TL) scintigraphy was performed 6-8 months after STEMI onset.Using BMIPP and TL, in the PA(-) subgroups, the iPoC(+) group had a significantly greater myocardial salvage ratio than the iPoC(-) group. iPoC was identified as an independent predictor of the myocardial salvage ratio. The HSP72 increase ratio was significantly elevated in the iPoC(+)PA(-) group. Importantly, the myocardial salvage effect in patients without PA was significantly correlated with the HSP72 increase ratio, which was greater in patients with iPoC.These results suggest the potential impact of iPoC via HSP72 induction on myocardial salvage; however, the effects may be limited to patients with STEMI without PA.

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Section: Discussionmentioning

confidence: 99%

Potential Effects of Ischemic Postconditioning and Changes in Heat Shock Protein 72 in Patients with Acute Myocardial Infarction without Prodromal Angina

Takeuchi,

Kitani,

Minoshima

et al. 2024

Int. Heart J.

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“…The extended follow-up study of the DANAMI-3-iPOST trial showed a long-term clinical benefit of local ischemic postconditioning. After a mean follow-up of 4.8 years, there was a significant reduction in the combined endpoint of cardiovascular mortality and hospitalization for heart failure, but only in the PCI-only subgroup (without thrombectomy) (15% vs. 22%, p = 0.023) [ 74 ]. The LIPSIA CONDITIONING trial, testing both local ischemic postconditioning alone and in combination with RIC, failed to reduce the combined endpoint of cardiac death, reinfarction, and new congestive heart failure at 6 months [ 72 ].…”

Section: Effect Of Ischemic Conditioning On Clinical Outcomes In Stem...mentioning

confidence: 99%

Reperfusion Injury: How Can We Reduce It by Pre-, Per-, and Postconditioning

Buske,

Desch,

Heusch

et al. 2023

JCM

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While early coronary reperfusion via primary percutaneous coronary intervention (pPCI) is established as the most efficacious therapy for minimizing infarct size (IS) in acute ST-elevation myocardial infarction (STEMI), the restoration of blood flow also introduces myocardial ischemia-reperfusion injury (IRI), leading to cardiomyocyte death. Among diverse methods, ischemic conditioning (IC), achieved through repetitive cycles of ischemia and reperfusion, has emerged as the most promising method to mitigate IRI. IC can be performed by applying the protective stimulus directly to the affected myocardium or indirectly to non-affected tissue, which is known as remote ischemic conditioning (RIC). In clinical practice, RIC is often applied by serial inflations and deflations of a blood pressure cuff on a limb. Despite encouraging preclinical studies, as well as clinical studies demonstrating reductions in enzymatic IS and myocardial injury on imaging, the observed impact on clinical outcome has been disappointing so far. Nevertheless, previous studies indicate a potential benefit of IC in high-risk STEMI patients. Additional research is needed to evaluate the impact of IC in such high-risk cohorts. The objective of this review is to summarize the pathophysiological background and preclinical and clinical data of IRI reduction by IC.

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“…Although the timely restoration of myocardial blood flow can reduce the size of the ischemic myocardium, revascularization may also aggravate the functional and structural impairment of the myocardium, thereby resulting in myocardial ischemia reperfusion injury (MIRI) [ 2 , 3 ]. Multiple therapeutic strategies have been applied to manage MIRI, including mechanical physiotherapy (e.g., ischemic pretreatment, ischemic post-treatment, and remote ischemic treatment) [ 4 , 5 , 6 ], and pharmacotherapy (e.g., adenosine, cyclosporine A and atrial natriuretic peptide) [ 7 , 8 , 9 ]. However, the efficacy of these approaches is limited.…”

Section: Introductionmentioning

confidence: 99%

Mechanism of Action of Flavonoids of Oxytropis falcata on the Alleviation of Myocardial Ischemia–Reperfusion Injury

et al. 2022

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Oxytropis falcata Bunge is a plant used in traditional Tibetan medicine, with reported anti-inflammatory and antioxidants effects and alleviation of myocardial ischemia reperfusion injury (MIRI). However, the underlying mechanism against MIRI and the phytochemical composition of O. falcata are vague. One fraction named OFF1 with anti-MIRI activity was obtained from O. falcata, and the chemical constituents were identified by ultra-high-performance liquid chromatography coupled with tandem mass spectrometry (UHPLC–MS). The potential targets and signaling pathways involved in the action of O. falcata against MIRI were predicted by network pharmacology analysis, and its molecular mechanism on MIRI was determined by in vitro assays. The results revealed that flavonoids are the dominant constituents of OFF1. A total of 92 flavonoids reported in O. falcata targeted 213 potential MIRI-associated factors, including tumor necrosis factor (TNF), prostaglandin-endoperoxide synthase 2 (PTGS2), and the NF-κB signaling pathway. The in vitro assay on H9c2 cardiomyocytes subjected to hypoxia/reoxygenation injury confirmed that the flavonoids in OFF1 reduced myocardial marker levels, apoptotic rate, and the inflammatory response triggered by oxidative stress. Moreover, OFF1 attenuated MIRI by downregulating the ROS-mediated JNK/p38MAPK/NF-κB pathway. Collectively, these findings provide novel insights into the molecular mechanism of O. falcata in alleviating MIRI, being a potential therapeutic candidate.

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Comparison of Effect of Ischemic Postconditioning on Cardiovascular Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention With Versus Without Thrombectomy

Cited by 8 publications

References 22 publications

Potential Effects of Ischemic Postconditioning and Changes in Heat Shock Protein 72 in Patients with Acute Myocardial Infarction without Prodromal Angina

Potential Effects of Ischemic Postconditioning and Changes in Heat Shock Protein 72 in Patients with Acute Myocardial Infarction without Prodromal Angina

Reperfusion Injury: How Can We Reduce It by Pre-, Per-, and Postconditioning

Mechanism of Action of Flavonoids of Oxytropis falcata on the Alleviation of Myocardial Ischemia–Reperfusion Injury

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