Literature DB >> 27379916

Impact of postconditioning with lactate-enriched blood on in-hospital outcomes of patients with ST-segment elevation myocardial infarction.

Takashi Koyama1, Masahito Munakata2, Takashi Akima2, Toshimi Kageyama3, Masaru Shibata3, Kazunori Moritani3, Hideaki Kanki2, Shiro Ishikawa2, Hideo Mitamura3.   

Abstract

BACKGROUND: Reperfusion injury offsets the beneficial effects of reperfusion therapy for ST-segment elevation myocardial infarction (STEMI). In our previous reports, postconditioning with lactate-enriched blood (PCLeB) induced excellent microcirculation recovery and less inflammation in STEMI patients. This study aimed to determine the in-hospital outcomes of STEMI patients treated using PCLeB.
METHODS: Fifty-five consecutive STEMI patients were treated using PCLeB (Age 66.6±13.8years, 76.4% men) within 12h of symptom onset. In our modified postconditioning protocol, the duration of each brief reperfusion was prolonged from 10s to 60s in a stepwise manner. Lactated Ringer's solution (20-30mL) was injected directly into the culprit coronary artery at the end of each brief reperfusion and the balloon was quickly inflated at the lesion site, whereby lactate could be trapped inside the ischemic myocardium. Each brief ischemic period lasted 60s. After 7cycles of balloon inflation and deflation, full reperfusion was performed. Thereafter, stenting was performed and percutaneous coronary intervention (PCI) was completed.
RESULTS: The mean corrected thrombolysis in myocardial infarction frame count was 20.1±10.1 after PCI completion. The mean peak serum creatine kinase and creatine kinase-MB levels were 2751±2227IU/L and 276±181IU/L respectively. None of the study patients died during their hospital stay or required continuation of oral diuretic or inotropic therapy for heart failure on discharge.
CONCLUSIONS: PCLeB led to zero in-hospital mortality and no overt heart failure on discharge in 55 consecutive STEMI patients undergoing reperfusion therapy.
Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Entities:  

Keywords:  C-reactive protein; Cardioprotection; Heart failure; Mortality; Reperfusion injury; TIMI frame count

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Year:  2016        PMID: 27379916     DOI: 10.1016/j.ijcard.2016.06.176

Source DB:  PubMed          Journal:  Int J Cardiol        ISSN: 0167-5273            Impact factor:   4.164


  4 in total

1.  Sodium Lactate Accelerates M2 Macrophage Polarization and Improves Cardiac Function after Myocardial Infarction in Mice.

Authors:  Jialiang Zhang; Fangyang Huang; Li Chen; Guoyong Li; Wenhua Lei; Jiahao Zhao; Yanbiao Liao; Yijian Li; Changming Li; Mao Chen
Journal:  Cardiovasc Ther       Date:  2021-06-05       Impact factor: 3.023

2.  Lactated Ringer's solution for preventing myocardial reperfusion injury.

Authors:  Takashi Koyama
Journal:  Int J Cardiol Heart Vasc       Date:  2017-04-07

3.  Exploring the role of dimethylarginine dimethylaminohydrolase-mediated reduction in tissue asymmetrical dimethylarginine levels in cardio-protective mechanism of ischaemic postconditioning in rats.

Authors:  Kamaldeep Kaur; Nirmal Singh; R K Dhawan
Journal:  Iran J Basic Med Sci       Date:  2019-12       Impact factor: 2.699

Review 4.  Clinical Applicability of Conditioning Techniques in Ischemia-Reperfusion Injury: A Review of the Literature.

Authors:  Kuldeep Kumar; Nirmal Singh; Amteshwar S Jaggi; Leonid Maslov
Journal:  Curr Cardiol Rev       Date:  2021
  4 in total

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