Objective: To evaluate the cardiac protective effects of ischemic postconditioning (IPC) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI).
Methods: Both foreign and Chinese databases including PubMed, EMbase, Cochrane library, and CNKI were searched to identify randomized controlled trials (RCTs) that reported the effects of IPC on the myocardial infarction size, myocardial blush grade (MBG), left ventricular ejection fraction (LVEF) and major adverse cardiac events (MACE). Two reviews assessed the quality of each trial and extracted data independently. The Cochrane Collaboration's RevMan 4.2.8 software was used for statistical analysis.
Results: Twelve studies were identified and the Meta-analysis included a total of 937 patients with AMI undergoing primary PCI with or without IPC. Pooled analysis of all studies demonstrated no significant reductions of peak CK and CK-MB with IPC relative to standard care. A secondary analysis of the studies didn't show improvements of left ventricular ejection fraction during hospitalization with IPC. However, the incidence of MACE within 3 month after primary PCI in IPC group was less than that in the control group (P = 0.04).
Conclusion: No significant benefit of IPC for reduction of myocardial infarct size as determined by peak creatine kinase and CK-MB release, as well as LVEF. The incidence of MACE was improved in patients who received IPC.