2021, 29(6):512-518.
Abstract:Aim To study the effect of remote ischemic postconditioning (RIPostC) on the clinical prognosis of patients with ST-segment elevation myocardial infarction (STEMI) who received direct percutaneous coronary intervention (PCI) and to evaluate the health economics. Methods A total of 309 patients with STEMI diagnosed in the First Affiliated Hospital of Xinjiang Medical University from February 2016 to October 2018 were enrolled in this prospective study.According to the random number table, the patients were divided into two groups:the RIPostC group (n=155) and the control group (n=154). Patients in RIPostC group completed three rounds of ischemic postconditioning of lower extremities before direct PCI. The area under creatine kinase isoenzyme (CK-MB), major adverse cardiac events (MACE) and direct medical expenses were compared between the two groups. The average out-of-hospital follow-up was 1.5 years. The incidence of out-of-hospital MACE and the direct medical expenses of re-admission were compared between the two groups. Results The cumulative release of CK-MB within 48 hours after admission in the RIPostC group was lower than that in the control group (P<0.05). The incidence of total MACE in the RIPostC group was lower than that in the control group (P<0.05). The incidence of out-of-hospital total MACE in the RIPostC group was lower than that in the control group (P<0.05), and the out-of-hospital mortality rate was lower than that in the control group (P<0.05). The cumulative incidence of MACE events in the two groups was compared by Kaplan-Meier curve. The results showed that the Kaplan-Meier curve was significantly separated 50 days after PCI, and the cumulative incidence of out-of-hospital total MACE in the RIPostC group was lower than that in the control group (P<0.05). The direct medical expenses during hospitalization and re-admission in the RIPostC group were lower than those in the control group (P<0.05), respectively. Conclusion As an adjuvant therapy in the treatment of PCI, RIPostC can not only improve the clinical prognosis of patients with STEMI, but also reduce the economic burden of patients.
2021, 29(8):688-694.
Abstract:Aim Patients with ST-elevation myocardial infarction (STEMI) were subjected to administer ischemic post-conditioning (IPOC) before conducting emergency treatment with percutaneous intervention (PCI). Changes in serum soluble apoptosis factor (sFas) and soluble apoptosis factor ligand (sFasL) and the left ventricular ejection fraction (LVEF) under echocardiography during the 1 postoperative year were investigated in patients, and changes in cardiac function in patients and the possible mechanisms were explored. Methods 90 patients with acute STEMI who underwent emergency PCI were randomly divided into three groups before treatment:routine PCI group, IPOC 45 s group and IPOC 60 s group. No intervention was given within 3 minutes after reperfusion of infarct-related artery (IRA) in routine PCI group. Within 1 minute after the opening of IRA, repeated low pressure (4~6 standard atmospheric pressure) filling and retraction of the balloon were performed at the upstream of the patients blood vessels for 3 times, each time lasting 45 s. The operation method of the IPOC 60 s group was the same as that of the IPOC45 s group, lasting 60 s each time. The levels of serum sFas and sFasL were measured before operation and 0 h, 24 h and 48 h after operation, and the changes of LVEF in the three groups were followed up for 1 month, 3 months, 6 months and 1 year. Results There was no significant difference in serum sFas, sFasL level among the three groups before operation and 0 h, 24 h after operation (all P>0.05). 48 hours after operation, the serum sFas, sFasL level decreased significantly in the IPOC 60 s group and the IPOC 45 s group compared with the routine group (all P<0.05). There was no significant difference in LVEF values among the three groups at 1 week, 1 month and 3 months after operation(all P>0.05), but at 6 months after operation, the values of LVEF in IPOC 60 s group and IPOC 45 s group were higher than those in routine group. One year after operation, the value of LVEF in IPOC 60 s group was higher than that in routine group(P<0.05). Conclusion Ischemic postconditioning 60 s reperfusion therapy after ischemia can significantly improve cardiac function in STEMI patients, and the mechanism may be related to the inhibitory effect of IPOC on apoptosis induced by myocardial reperfusion.
2013, 21(5):477-480.
Abstract:Ischemic postconditioning had been observed to reduce infarct size and cell apoptosis on myocardial ischemia-reperfusion injury, and was also associated with a reduction in endothelial cell dysfunction and so on. Postconditioning is a fairly simple strategy, and seems possible to be applied in patients. We will review the advancements of protective effects and the mechanisms in myocardial ischemic postconditioning. The operability of postconditioning in clinical application makes it the focus and hotspots in the field of cardiovascular research in recent years. We will review the clinical application and study progress of myocardial ischemic postconditioning.
2012, 20(2):130-134.
Abstract:AimTo observe whether rosuvastatin postconditioning (RPO) and ischemic postconditioning (IPO) could attenuate ischemia-reperfusion injury (IRI) in T2DM rats, and to investigate the potential cardioprotective mechanisms involved.MethodsInduced by streptozotocin plus nicotinamide, a T2DM rat model was successfully created in 54 healthy Wistar male rats, which were randomly allocated into seven groups (n=9): Sham group, IRI group, RPO+IPO group, 5-HD group, diazoxide group, HMR-1098 group, and Cromakalim group.Infarct size, ultrastructure, serum cTnT were determined at the end of ischemia-reperfusion, which underwent 45 min ischemia and 120 min reperfusion.ResultsCompared with IRI group, the myocardial infarct size significantly decreased in RPO+IPO group and diazoxide group, HMR-1098 group, Cromakalim group (p<0.05).The myocardial infarct size in 5-HD group significantly increased than that in RPO group and diazoxide group, HMR-1098 group, and Cromakalim group (p<0.05).TEM revealed that the myocardial cell mitochondria ultrastmctural damages were serious in IRI group and 5-HD group.In RPO+IPO group, diazoxide group, HMR-1098 group and Cromakalim group, the structure of most mitochondria maintained as originally on the whole.As compared with IRI group, the level of cTnT in RPO+IPO group and diazoxide group, HMR-1098 group, Cromakalim group was significantly reduced (p<0.05).The level of cTnT in 5-HD group was significantly increased than that in RPO+IPO group and diazoxide group, HMR-1098 group, Cromakalim group (p<0.05).ConclusionsRPO+IPO could significantly attenuate IRI in vivo T2DM rats.mitoKATP channel but not sarcKATP channel plays the major role in the protection effects of rosuvastatin postconditioning.