Abstract 23232: NHLBI-sponsored Trial of Postconditioning During PCI for ST-elevation Myocardial Infarction

Introduction: Postconditioning (PC) is a powerful mechanism to reduce infarct size in animals following ischemia / reperfusion (I/R) injury. However, clinical trials outside the United States have failed to demonstrate a consistent benefit of this technique when performed at the time of primary PCI for STEMI. This may be due in part to patient selection since patients with pre-infarction angina or prolonged ischemic times or TIMI score of 1 were not routinely excluded. To be effective, PC must be performed immediately at the time of reperfusion following a limited ischemic time. We performed the first randomized PC trial in the United States sponsored by the NHLBI with the goal of studying an optimized patient population without confounders of pre-infarction angina or collateral blood flow and with ischemic times between 1 and 6 hours and TIMI flow of 0 who could undergo cardiac MRI measurement of infarct size and myocardial salvage 1-2 days later. Methods and Results: We enrolled 101 patients at a single...