Ischemic Postconditioning During Primary PCI for Patients With STEMI Heart Attack Interview with:

Thomas Engstrøm Senior Consultant dr. sci., MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark

Dr. Engstrøm

Thomas Engstrøm  MD, PhD
The Heart Center | Rigshospitalet | University of Copenhagen | Denmark
Professor in cardiology | University of Lund | Sweden
Adjunct professor in cardiology | University of Aalborg | Denmark What is the background for this study? What are the main findings?

Response: Timely reperfusion by primary angioplasty (primary PCI) in patients with ST-elevation myocardial infarction is mandatory. However reperfusion it self can harm the myocardium – so called reperfusion injury. During a number of years ischemic postconditioning (iPOST) by repetitive interruptions of blood flow after reperfusion has been a promising technique to address reperfusion damage.

The trial investigated the effect of iPOST in 1200 patients treated with primary PCI and in addition either iPOST or conventional angioplasty. What should readers take away from your report?

Response: The trial was neutral and thus a large number of positive clinical studies on surrogate endpoints could not be translated into a clinical outcome study. What recommendations do you have for future research as a result of this study?

Response: Since reperfusion injury is real and it may in some patients account for up to 50% of the final myocardial injury research within the area should be continued. Remote ischemic conditioning and pharmacological compounds are candidates as future treatment modalities. Thank you for your contribution to the community.


Engstrøm T, Kelbæk H, Helqvist S, Høfsten DE, Kløvgaard L, Clemmensen P, Holmvang L, Jørgensen E, Pedersen F, Saunamaki K, Ravkilde J, Tilsted H, Villadsen A, Aarøe J, Jensen SE, Raungaard B, Bøtker HE, Terkelsen CJ, Maeng M, Kaltoft A, Krusell LR, Jensen LO, Veien KT, Kofoed KF, Torp-Pedersen C, Kyhl K, Nepper-Christensen L, Treiman M, Vejlstrup N, Ahtarovski K, Lønborg J, Køber L, for the Third Danish Study of Optimal Acute Treatment of Patients With ST Elevation Myocardial Infarction–Ischemic Postconditioning (DANAMI-3–iPOST) Investigators. Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial InfarctionA Randomized Clinical Trial. JAMA Cardiol. Published online March 01, 2017. doi:10.1001/jamacardio.2017.0022

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 1, 2017 by Marie Benz MD FAAD