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Original research article
Influence of cardiovascular risk factors on infarct size and interaction with mechanical ischaemic postconditioning in ST-elevation myocardial infarction
  1. Sophie Pichot1,
  2. Nathan Mewton1,2,
  3. Theodora Bejan-Angoulvant3,
  4. Francois Roubille1,
  5. Gilles Rioufol1,2,
  6. Céline Giraud1,
  7. Inesse Boussaha1,
  8. Olivier Lairez4,
  9. Meyer Elbaz4,
  10. Christophe Piot5,6,
  11. Denis Angoulvant7 and
  12. Michel Ovize1,2
  1. 1Cardiology Division, Hôpital Cardiologique Louis Pradel, Centre d'Investigation Clinique, Hospices Civils de Lyon, Lyon, France
  2. 2Inserm UMR-1060, CarMeN Unit, Université Claude Bernard Lyon1, Lyon, France
  3. 3CHRU Tours, Service de Pharmacologie, Hôpital Bretonneau; CNRS UMR 7292, Université François Rabelais, GICC, Tours, France
  4. 4Hôpital Rangueuil, Université Paul Sabatier, Toulouse, France
  5. 5Hopital Arnaud de Villeneuve, Université de Montpellier I and II, Montpellier, France
  6. 6Inserm U661, Montpellier, France
  7. 7CHRU Tours, Hôpital Trousseau, Université François Rabelais EA 4245, Tours, France
  1. Correspondence to Dr Nathan Mewton; nathan.mewton{at}


Objective Previous studies have shown that mechanical postconditioning (PostC) significantly reduces infarct size (IS) in patients with acute myocardial infarction. Our objective was to assess the influence of traditional cardiovascular (CV) risk factors on IS and their interaction with ischaemic PostC in patients with acute ST-elevation myocardial infarction (STEMI).

Methods The study population was constituted from the clinical database pooling of four previously published PostC prospective, multicentre, randomised, open-label controlled trials with identical inclusion criteria. Patients with STEMI, presenting within 12 h of symptoms onset referred for percutaneous coronary intervention, were included. Mechanical ischaemic PostC was performed by four repeated cycles of inflation–deflation of the angioplasty balloon within 1 min of reflow, while the control group underwent no intervention. IS was assessed by measuring total creatine kinase release over 72 h.

Results 173 patients, aged 58±12 years, 76% males, 48% anterior infarct were included (82 in the PostC group, 91 in the control group). IS was significantly reduced in the PostC compared to the control group (71.7±41.6 vs 88.2±54.5×103 arbitrary units; p=0.027). After adjustment for abnormally contracting segments, older patients had smaller IS and smokers had larger IS. Gender, diabetes, hypertension, dyslipidemia and obesity did not have any significant effect on IS. Multivariate regression analysis showed that none of the traditional risk factors had a significant impact on the cardioprotective effect of mechanical ischaemic PostC.

Conclusions The present analysis suggests that the cardioprotective effect of mechanical PostC is not influenced by traditional CV risk factors that are prevalent in patients with STEMI.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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