The effects of gradual ischemic postconditioning treatment on patients with STEMI

HAN Zeng-lei; SUN Xue-yu; CAO Qing-bo

摘要：Background When patients suffering with ST-segment elevation myocardial infarction(STEMI)undergo an percutaneous coronary intervention(PCI)and open the infarct-related coronary artery(IRCA),a myocardial isch-emia reperfusion injury(MIRI)will occur.This leads to severe complications,such as an enlarged myocardial in-farction area,reperfusion arrhythmia,and heart failure.Finding ways to mitigate the effects of MIRIs is therefore important.Our study aims to observe the effect and significance of the gradual ischemic postconditioning(IPOC)treatment on MIRI and autonomic nerves system(ANS)in patients with STEMI during PCIs.Methods We took the 121 patients diagnosed with STEMI that had been hospitalized in the cardiology department of our hospital from March 2019 to September 2020,and divided them into a control group(60 cases)and treatment group(61 cas-es).The control group received conventional PCI treatment,and the treatment group received gradual IPOC treat-ment.Results The gradual IPOC group was shown to achieve significantly better results than the control group(P＜0.01)in the following:reduction of the incidence rate of arrhythmia cases during PCI,increase in proportion of ST-segment resolution at 24 hours after PCI,suppression of the postoperative overexcitement of the sympathetic and vagus nerve systems,recovery of the cardiac autonomic nerve function,reduction of cTnT,NT-proBNP and hs-CRP concentrations,and improvement of LVEF value.Conclusion During emergency PCIs for patients with STEMI,the operation of an gradual IPOC can lessen the myocardial infarction area,reduce inflammation,improve heart function,reduce reperfusion arrhythmia,and promote the recovery of cardiac autonomic nerve function,there-by reduce MIRI and benefitting patients.