{"id":"555cef05876f","type":"article","url":"https://hartvaat.nl/2017/05/01/ischemische-postconditionering-bij-primaire-pci-voor-stemi-jama-cardiology/","title":"Ischemische postconditionering bij primaire PCI voor STEMI: JAMA Cardiology","title_en":"Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"JAMA cardiology","doi":"10.1001/jamacardio.2017.0022","source_url":"https://doi.org/10.1001/jamacardio.2017.0022","authors":["Thomas Engstrøm","Henning Kelbæk","Steffen Helqvist","Dan Eik Høfsten","Lene Kløvgaard","Peter Clemmensen","Lene Holmvang","Erik Jørgensen","Frants Pedersen","Kari Saunamaki","Jan Ravkilde","Hans-Henrik Tilsted","Anton Villadsen","Jens Aarøe","Svend Eggert Jensen","Bent Raungaard","Hans E Bøtker","Christian J Terkelsen","Michael Maeng","Anne Kaltoft","Lars R Krusell","Lisette O Jensen","Karsten T Veien","Klaus Fuglsang Kofoed","Christian Torp-Pedersen","Kasper Kyhl","Lars Nepper-Christensen","Marek Treiman","Niels Vejlstrup","Kiril Ahtarovski","Jacob Lønborg","Lars Køber"],"significance":6,"published":"2017-05-01","source_date":"2017-05-01","image":"","kennis":[],"congress":"","summary_en":"This JAMA Cardiology trial tested ischemic postconditioning during primary PCI for STEMI, evaluating whether controlled brief reocclusions after stent deployment reduce infarct size through cardioprotective conditioning.","created":"2026-07-03T10:26:41Z","updated":"2026-07-03T13:26:00Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"JAMA Cardiology trial naar het effect van ischemische postconditionering tijdens primaire PCI bij STEMI. Onderzocht of gecontroleerde reperfusie de myocardschade kan beperken.","abstract_original":"IMPORTANCE: Ischemic postconditioning of the heart during primary percutaneous coronary intervention (PCI) induced by repetitive interruptions of blood flow to the ischemic myocardial region immediately after reopening of the infarct-related artery may limit myocardial damage. OBJECTIVE: To determine whether ischemic postconditioning can improve the clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). DESIGN, SETTING, AND PARTICIPANTS: In this multicenter, randomized clinical trial, patients with onset of symptoms within 12 hours, STEMI, and thrombolysis in myocardial infarction (TIMI) grade 0-1 flow in the infarct-related artery at arrival were randomized to conventional PCI or postconditioning. Inclusion began on March 21, 2011, through February 2, 2014, and follow-up was completed on February 2, 2016. Analysis was based on intention to treat. INTERVENTIONS: Patients were randomly allocated 1:1 to conventional primary PCI, including stent implantation, or postconditioning performed as 4 repeated 30-second balloon occlusions followed by 30 seconds of reperfusion immediately after opening of the infarct-related artery and before stent implantation. MAIN OUTCOME AND MEASURES: A combination of all-cause death and hospitalization for heart failure. RESULTS: During the inclusion period, 1234 patients (975 men [79.0%] and 259 women [21.0%]; mean [SD] age, 62 [11] years) underwent randomization in the trial. Median follow-up was 38 months (interquartile range, 24-58 months). The primary outcome occurred in 69 patients (11.2%) who underwent conventional primary PCI and in 65 (10.5%) who underwent postconditioning (hazard ratio, 0.93; 95% CI, 0.66-1.30; P = .66). The hazard ratios were 0.75 (95% CI, 0.49-1.14; P = .18) for all-cause death and 0.99 (95% CI, 0.60-1.64; P = .96) for heart failure. CONCLUSIONS AND RELEVANCE: Routine ischemic postconditioning during primary PCI failed to reduce the composite outcome of death from any cause and hospitalization for heart failure in patients with STEMI and TIMI grade 0-1 flow at arrival. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01435408."}