Meta-analysis of the effects of ischemic postconditioning on structural pathology in ST-segment elevation acute myocardial infarction
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Baohui Lou1, Yadong Cui1,3, Haiyang Gao2 and Min Chen1
1Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China
2Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, China
3Graduate School of Peking Union Medical College, Beijing, China
Min Chen, email: [email protected]
Keywords: local ischemic postconditioning; remote ischemic postconditioning; acute myocardial infarction; cardiac magnetic resonance imaging; structural effect
Received: June 19, 2017 Accepted: October 05, 2017 Published: December 16, 2017
In this meta-analysis, we assessed cardiac magnetic resonance imaging data to determine the effects of local and remote ischemic postconditioning (LPoC and RPoC, respectively) on structural pathology in ST-segmentel elevation acute myocardial infarction (STEMI).We searched the Pubmed, Embase and Cochrane Library databases up to May 2017 and included 12 randomized controlled trials (10 LPoC and 2 RPoC)containing 1069 study subjects with thrombolysis in myocardial infarction flow grade 0~1. Weighed mean difference (WMD), standardized mean difference (SMD), and odds ratio (OR) were used for the pooled analysis. Random-effect model was used for the potential clinical inconsistency. LPoC and RPoC increased the myocardial salvage index (n = 5; weighted mean difference (WMD) = 5.52; P = 0.005; I2 = 76.0%), and decreased myocardial edema (n = 7; WMD = –3.35; P = 0.0009; I2 = 18.0%). However, LPoC and RPoC did not reduce the final infarct size (n = 10; WMD = –1.01; P > 0.05; I2 = 68.0%), left ventricular volume (n = 10; standardized mean difference = 0.23; P > 0.05; I2 = 93.0%), the incidence of microvascular obstruction (n = 6; OR = 0.99; P > 0.05; I2 = 0.0%) or the extent of microvascular obstruction (n = 3; WMD = –0.09; P > 0.05; I2 = 6.0%). This meta-analysis shows that LPoC and/or RPoC improves myocardial salvage and decreases myocardial edema in STEMI patients without affecting final infarct size, left ventricular volume or microvascular obstruction.
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