Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Valve regurgitation in patients surviving endocarditis and the subsequent risk of heart failure

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Alcohol septal ablation in patients with severe septal hypertrophy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Outcome after heart-lung or lung transplantation in patients with Eisenmenger syndrome

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Significantly increased risk of all-cause mortality among cardiac patients feeling lonely

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Role of the lymphatic vasculature in cardiovascular medicine

    Publikation: Bidrag til tidsskriftReviewForskningpeer review

  1. Switching from Vitamin K Antagonist to Dabigatran in Atrial Fibrillation: Differences According to Dose

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Vitamin K antagonists vs. direct oral anticoagulants after transcatheter aortic valve implantation in atrial fibrillation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Pulmonary Arterial Enlargement in Well-Treated Persons With Human Immunodeficiency Virus

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Left ventricular myocardial crypts: morphological patterns and prognostic implications

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Left ventricular trabeculation and major adverse cardiovascular events: the Copenhagen General Population Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVE: The Third Danish Study of Optimal Acute Treatment of Patients with ST-segment Elevation Myocardial Infarction - Ischaemic Postconditioning (DANAMI-3-iPOST) did not show improved clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) treated with ischaemic postconditioning. However, the use of thrombectomy was frequent and thrombectomy may in itself diminish the effect of ischaemic postconditioning. We evaluated the effect of ischaemic postconditioning in patients included in DANAMI-3-iPOST stratified by the use of thrombectomy.

METHODS: Patients with STEMI were randomised to conventional primary percutaneous coronary intervention (PCI) or ischaemic postconditioning plus primary PCI. The primary endpoint was a combination of all-cause mortality and hospitalisation for heart failure.

RESULTS: From March 2011 until February 2014, 1234 patients were included with a median follow-up period of 35 (interquartile range 28 to 42) months. There was a significant interaction between ischaemic postconditioning and thrombectomy on the primary endpoint (p=0.004). In patients not treated with thrombectomy (n=520), the primary endpoint occurred in 33 patients (10%) who underwent ischaemic postconditioning (n=326) and in 35 patients (18%) who underwent conventional treatment (n=194) (adjusted hazard ratio (HR) 0.55 (95%confidence interval (CI) 0.34 to 0.89), p=0.016). In patients treated with thrombectomy (n=714), there was no significant difference between patients treated with ischaemic postconditioning (n=291) and conventional PCI (n=423) on the primary endpoint (adjusted HR 1.18 (95% CI 0.62 to 2.28), p=0.62).

CONCLUSIONS: In this post-hoc study of DANAMI-3-iPOST, ischaemic postconditioning, in addition to primary PCI, was associated with reduced risk of all-cause mortality and hospitalisation for heart failure in patients with STEMI not treated with thrombectomy.

TRIAL REGISTRATION NUMBER: NCT01435408.

OriginalsprogEngelsk
TidsskriftHeart (British Cardiac Society)
Vol/bind106
Udgave nummer1
Sider (fra-til)24-32
Antal sider9
ISSN1355-6037
DOI
StatusUdgivet - jan. 2020

Bibliografisk note

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

ID: 57662981