Results of implementation of ischemic postconditioningduring primary percutaneous coronary intervention in patientswith acute ST-segment elevation myocardial infarction

Authors: Harelikau A.V.1, Karpelev G.M.1, Cheherava T.I.2, Ostrovskiy Yu.P.3

Company: 1 Mogilev Regional Hospital, ulitsa Byalynitskogo-Biruli, 12, Mogilev, 212026, Republic of Belarus;
2 Mogilev State A. Kuleshov University, ulitsa Kosmonavtov, 1, Mogilev, 212022, Republic of Belarus;
3 Republican Scientific and Practical Centre “Cardiology”, ulitsa Rozy Lyuksemburg, 110B, Minsk, 220036, Republic of Belarus

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Type:  Original articles


For citation: Harelikau A.V., Karpelev G.M., Cheherava T.I., Ostrovskiy Yu.P. Results of implementation of ischemic postconditioning during primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Creative Cardiology. 2019; 13 (2): 114–28 (in Russ.). DOI: 10.24022/1997-3187-2019-13-2-114-128

Received / Accepted:  23.05.2019/29.05.2019

Keywords: acute ST-segment elevation myocardial infarction myocardial reperfusion injury ischemic postconditioning

Full text:  



Objective. To assess the effectiveness of ischemic postconditioning in patients with acute ST-segment elevation myocardial infarction (STEMI).

Material and methods. Results of treatment of 60 patients with STEMI, aged 32–65 years with complete occlusion of one of major coronary arteries, ST-segment elevation more than 0.1 mV in more than 2 contiguous leads and presentation within 6 hours after chest pain onset were analyzed. 31 patients were randomized to control, and 29 to postconditioning group. All patients underwent standard primary percutaneous coronary intervention. Within 1 minute after coronary blood flow restoration postconditioning group patients additionally underwent ischemic postconditioning procedure by a series of five consecutive short cycles of occlusion (60 s) / opening (30 s) of coronary artery.

Results. Final infarct size was smaller in postconditioning group (21.0±10.2% in control group, 6.3±7.3% in postconditioned group, p=0.0001) according to single photon emission computed tomography (SPECT) data. Myocardial infarction expansion was observed in 4 patients from control group. Myocardial injury biomarkers' activity was higher in control group: difference in area under the enzyme activity curve for creatine kinase (CK) was 80% (p=0.0025), for creatine kinase isoenzyme MB fraction (CK-МВ) 62% (p=0.015), for aspartate aminotransferase (AST) 57% (p=0.003), for lactate dehydrogenase (LDH) 82% (p=0.003) and for LDH-1, 2 – 99% (p=0.0009). Assessment of left ventricle contractile function by means of SPECT data showed ejection fraction of 39.4±8.2% in control group and of 48.4±6.3% in postconditioning group (p=0.0001), and by means of echocardiography 51.6±8.5% and 61.5±7.9%, respectively (p=0.0001).

Conclusion. Ischemic postconditioning in patients with STEMI effectively prevents reperfusion injury, contributes to decrease in final infarct size and leads to systolic left ventricle function improvements.


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About Authors

  • Andrei V. Harelikau, Postgraduate, Head of Department, Endovascular Surgeon, ORCID
  • Genadi M. Karpelev, Cand. Med. Sc., Head of Department, Radiologist;
  • Tat'ana I. Cheherava, Cand. Tech. Sc., Associate Professor;
  • Yuriy P. Ostrovskiy, Dr Med. Sc., Professor, Academician of the National Academy of Sciences of Belarus, Head of Laboratory, Cardiac Surgeon

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery