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Design and Methodologies of the POSTconditioning during Coronary Angioplasty in Acute Myocardial Infarction (POST-AMI) Trial

2010; Karger Publishers; Volume: 116; Issue: 2 Linguagem: Inglês

10.1159/000316967

1421-9751

Giuseppe Tarantini, Enrico Favaretto, Massimo Napodano, Martina Perazzolo Marra, Luisa Cacciavillani, Luciano Babuin, Andrea Giovagnoni, Pietro Renda, Valeria De Biasio, Mario Plebani, Monica Mion, Martina Zaninotto, Flavio Mistrorigo, Marco Panfili, Giambattista Isabella, Claudio Bilato, Sabino Iliceto,

Cardiovascular Function and Risk Factors

<i>Background:</i> Reperfusion remains the definitive treatment for acute myocardial infarction (AMI), but restoring blood flow carries the potential to exacerbate the ischemia-related injury. Postconditioning might modify reperfusion-induced adverse events. <i>Study Design:</i> The POSTconditioning during Coronary Angioplasty in Acute Myocardial Infarction (POST-AMI) trial is a single-center, prospective, randomized study, with a planned inclusion of 78 patients with ST-elevation AMI. Patients will be randomly assigned to the postconditioning arm [primary angioplasty (PA) and stenting followed by brief episodes of ischemia-reperfusion early after recanalization] or non-postconditioning arm. All patients will be treated medically according to current international guidelines, including glycoprotein IIb/IIIa inhibitors before PA. The primary end point is to evaluate whether postconditioning, compared to plain PA, reduces infarct size estimated by cardiac magnetic resonance (CMR) at 30 ± 10 days after the AMI. Secondary end points are microvascular obstruction observed at CMR, ST-segment resolution, angiographic myocardial blush grade <2, non-sustained/sustained ventricular tachycardia in the 48 h following PA, left ventricular remodeling and function at follow-up CMR, and the reduction of major adverse cardiac events at 30 days and 6 months. <i>Conclusion:</i> The POST-AMI trial will evaluate the usefulness of postconditioning in limiting infarct size during the early and late phases after AMI.