Myocardial Protective Effects Of Ischemic Postconditioning And Pharmacologic Postconditioning On Elective Percutaneous Coronary Intervention In Patients With Actue Myocardial Infarction

Objective:To explore myocardial protective effects of ischemic postconditioning and pharmacologic postconditioning on elective percutaneous coronary intervention in patients with actue myocardial infarction.Methods:64patients diagnosed with AMI who needed elective PCI were randomly assigned to3groups:Control group with16patients, who were given only reperfusion. Nicorandil group with21patients, who were received5mg peroral nicorandil third a day, Ipost group with27patients, who were initiated for30s reperfusion followed by30s of reocclusion, repeated for three cycles during the first minute of reperfusion. All patients were given PCI7days after conventional medical treatment.Cardiac troponin(cTnT), creatine kinase-MB(CK-MB) were measured before and0,12,24h after PCI, neutrophilic granulocyte was measured before and24h after PCI, corrected TIMI frame count(CTFC) was measured in PCI, wall motion score index(WMSI) and left ventricular ejection fraction(LVEF) were measured before and6months after PCI.Results:cTnT and CK-MB were higher24h after PCI (cTnT:0.075±0.015ng/ml,0.036±0.009ng/ml vs.0.039±0.009ng/ml, P<0.05; CK-MB:1.92±0.18ng/ml,1.69±0.09ng/ml vs.1.71±0.17ng/ml,P<0.05); CTFC was slower in control group (31.19±2.86,26.43±1.57vs.27.19±1.47, P<0.05); neutrophilic granulocyte was higher[(6.94±0.74)×109/L,(5.98±0.51)×109/L vs.(5.80±0.50)×109/L,P<0.05]; than those of other groups.6months later LVEF was lower (61.19±0.83%,64.19±1.91%vs.63.44±1.40%,P<0.05), WMSI was higher in control group (1.50±0.52,1.14±0.36 vs.1.15±0.36, P<0.05); than those of other groups. There were no significant difference between nicorandil group, and ipost group.Conclusions:Nicorandil pharmacologic postconditioning has the similar myocardial protective effect with ischemic postconditioning durig elective PCI in patients with AMI.