Local Ischemic Postconditioning during Primary Percutaneous Coronary Intervention: A Meta-Analysis

Objectives: To investigate current evidence linking ischemic postconditioning (IPC) to cardioprotection in patients receiving primary percutaneous coronary intervention (PCI). Methods: We performed searches of PubMed, Embase, MEDLINE and Cochrane databases from January 1998 to May 2011 for identifying relevant studies comparing IPC with usual care in patients undergoing primary PCI. A meta-analysis of eligible studies was assessed by Review Manager 5.0. Results: Thirteen studies were eligible. Compared to the control, observed outcomes such as peak creatine kinase [weighted mean difference (WMD) -537.48, 95% confidence interval (Cl) -779.32 to -295.65 IU/l], peak creatine kinase-myocardial band (WMD -61.11,95% Cl -76.56 to -45.66 U/l), complete ST-segment resolution (risk ratio 1.38, 95% Cl 1.07 to 1.77), blush grade during reflow (WMD 0.64, 95% Cl 0.49 to 0.78), corrected TIMI frame count, single-photon emission computed tomography determining infarct size, long-term left ventricular ejection fraction and short-term and long-term wall motion score indexes were improved in IPC group, with less occurrence of heart failure during the 3-month to 3.4-year follow-up. Conclusions: Though current evidence indicates that IPC provides potential cardioprotection to patients receiving primary PCI, larger adequately powered studies should be undertaken to confirm its advantages. Copyright (C) 2012 S. Karger AG, Basel