Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis
Objectives This study aimed to perform a meta-analysis of the short-term impact of ischaemic postconditioning (IPoC) on myocardial injury in ST elevation myocardial infarction (STEMI) using surrogate cardiac biomarkers.Methods Eligible studies were identified using several article databases. Randomi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-01-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/11/1/e002281.full |
| _version_ | 1797339262363893760 |
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| author | Udi Nussinovitch Dennis Boyle Idan Bergman Shaul Gelikas Yehuda Wexler Omri Braver |
| author_facet | Udi Nussinovitch Dennis Boyle Idan Bergman Shaul Gelikas Yehuda Wexler Omri Braver |
| author_sort | Udi Nussinovitch |
| collection | DOAJ |
| description | Objectives This study aimed to perform a meta-analysis of the short-term impact of ischaemic postconditioning (IPoC) on myocardial injury in ST elevation myocardial infarction (STEMI) using surrogate cardiac biomarkers.Methods Eligible studies were identified using several article databases. Randomised controlled trials published between 1 January 2000 and 1 December 2021 comparing IPoC to standard of therapy in STEMI patients were included in the search. Outcomes included surrogates of myocardial injury, specifically peak troponin, creatine-kinase (CK) and CK myoglobin binding (CK-MB) enzyme levels.Results 11 articles involving 1273 patients reported on CK-MB and 8 studies involving 505 patients reported on CK. Few studies used troponin as an outcome, thus, a subanalysis of troponin dynamics was not performed. Meta-regression analysis demonstrated no significant effect of IPoC on peak CK-MB (effect size −0.41, 95% CI −1.15 to 0.34) or peak CK (effect size −0.42, 95% CI −1.20 to 0.36). Linear regression analysis demonstrated a significant correlation between a history of smoking and CK-MB in the IPoC group (p=0.038).Conclusions IPoC does not seem to protect against myocardial injury in STEMI, except possibly in smokers. These results resonate with some studies using imaging techniques to ascertain myocardial damage. More research using troponin and cardiac imaging should be pursued to better assess the effects of IPoC on cardiovascular outcomes in STEMI. |
| first_indexed | 2024-03-08T09:43:26Z |
| format | Article |
| id | doaj.art-1b0c6492b2994487ad0924a123ac946c |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-03-08T09:43:26Z |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-1b0c6492b2994487ad0924a123ac946c2024-01-29T18:35:12ZengBMJ Publishing GroupOpen Heart2053-36242024-01-0111110.1136/openhrt-2023-002281Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysisUdi Nussinovitch0Dennis Boyle1Idan Bergman2Shaul Gelikas3Yehuda Wexler4Omri Braver5Division of Cardiovascular Medicine, Stanford University, Palo Alto, CA, USAWestchester Medical Center, Valhalla, New York, USARabin Medical Center Beilinson Hospital, Petah Tikva, IsraelSheba Medical Center, Tel Hashomer, IsraelTechnion Israel Institute of Technology The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, IsraelBarzilai Medical Center, Ashkelon, IsraelObjectives This study aimed to perform a meta-analysis of the short-term impact of ischaemic postconditioning (IPoC) on myocardial injury in ST elevation myocardial infarction (STEMI) using surrogate cardiac biomarkers.Methods Eligible studies were identified using several article databases. Randomised controlled trials published between 1 January 2000 and 1 December 2021 comparing IPoC to standard of therapy in STEMI patients were included in the search. Outcomes included surrogates of myocardial injury, specifically peak troponin, creatine-kinase (CK) and CK myoglobin binding (CK-MB) enzyme levels.Results 11 articles involving 1273 patients reported on CK-MB and 8 studies involving 505 patients reported on CK. Few studies used troponin as an outcome, thus, a subanalysis of troponin dynamics was not performed. Meta-regression analysis demonstrated no significant effect of IPoC on peak CK-MB (effect size −0.41, 95% CI −1.15 to 0.34) or peak CK (effect size −0.42, 95% CI −1.20 to 0.36). Linear regression analysis demonstrated a significant correlation between a history of smoking and CK-MB in the IPoC group (p=0.038).Conclusions IPoC does not seem to protect against myocardial injury in STEMI, except possibly in smokers. These results resonate with some studies using imaging techniques to ascertain myocardial damage. More research using troponin and cardiac imaging should be pursued to better assess the effects of IPoC on cardiovascular outcomes in STEMI.https://openheart.bmj.com/content/11/1/e002281.full |
| spellingShingle | Udi Nussinovitch Dennis Boyle Idan Bergman Shaul Gelikas Yehuda Wexler Omri Braver Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis Open Heart |
| title | Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis |
| title_full | Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis |
| title_fullStr | Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis |
| title_full_unstemmed | Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis |
| title_short | Effect of ischaemic postconditioning on markers of myocardial injury in ST-elevation myocardial infarction: a meta-analysis |
| title_sort | effect of ischaemic postconditioning on markers of myocardial injury in st elevation myocardial infarction a meta analysis |
| url | https://openheart.bmj.com/content/11/1/e002281.full |
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