PT  - JOURNAL ARTICLE
AU  - Sophie Pichot
AU  - Nathan Mewton
AU  - Theodora Bejan-Angoulvant
AU  - Francois Roubille
AU  - Gilles Rioufol
AU  - Céline Giraud
AU  - Inesse Boussaha
AU  - Olivier Lairez
AU  - Meyer Elbaz
AU  - Christophe Piot
AU  - Denis Angoulvant
AU  - Michel Ovize
TI  - Influence of cardiovascular risk factors on infarct size and interaction with mechanical ischaemic postconditioning in ST-elevation myocardial infarction
AID  - 10.1136/openhrt-2014-000175
DP  - 2015 Aug 01
TA  - Open Heart
PG  - e000175
VI  - 2
IP  - 1
4099  - http://openheart.bmj.com/content/2/1/e000175.short
4100  - http://openheart.bmj.com/content/2/1/e000175.full
SO  - Open Heart2015 Aug 01; 2
AB  - 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.