EuroPCR25th annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Paris20-23 May 2014

These highlights have been recommended by a group of cardiologists who attended EuroPCR, compiled by an external medical writer

and sponsored by AstraZeneca Pty Limited, ABN 54 009 682 311, 5 Alma Road North Ryde NSW 2113, Australia. AU-BRI001132

EuroPCR 2014Paris

20-23 May 2014

Increasing myocardial salvage in the era of primary PCI:Ischaemic conditioning

Commentary:

Associate Professor David EcclestonRoyal Melbourne Hospital

Date of preparation May 2014 │BRI001132

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• These highlights have been suggested by a group of cardiologists who attended EuroPCR 2014, compiled by an external medical writer and sponsored by AstraZeneca. 

• AstraZeneca has obtained permission from EuroPCR, to utilise the selected content for educational purposes.

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AstraZeneca Pty Ltd, Alma Road, North Ryde 2113 ABN: 54 009 682 311

EuroPCR 2014Paris

20-23 May 2014

EuroPCR 2014Paris

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EuroPCR 2014Paris

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Preconditioning during ambulance transport increases salvage index from 0.55 to 0.75: Study in 333 patients

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Preconditioning during ambulance transport: Follow-up to 3.8 years

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Postconditioning: Benefits from repeated balloon inflation/deflation after stenting

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Pharmacological postconditioning

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• There is limited scope to improve outcomes for patients with STEMI through further reductions in door-to-balloon times.

• Reducing the impact of reperfusion injury may be one strategy to lessen the consequences of STEMI. Reperfusion injury occurs very rapidly – within minutes – and cannot be reversed.

• A well-conducted study on preconditioning by upper arm compression in the ambulance demonstrated impressive reductions in infarct size and the incidence of heart failure, LV dysfunction and need for defibrillation.

• Two studies also demonstrated benefits in reduced CK release and infarct size by SPECT from post-conditioning in the cath lab.

Commentary: Associate Professor David Eccleston

EuroPCR 2014Paris

20-23 May 2014

• Ischaemic remote- and post-conditioning are relatively simple and inexpensive therapies. These promising results suggest a strategy to further improve the outcomes in STEMI.

• A better understanding of the relevant biological processes would help clinicians to assess the role of preconditioning in relation to existing treatment strategies.

• A number of small trials of physical and pharmacological therapy have suggested that reperfusion injury can be reduced, however further assessment in large scale clinical trials is needed before considering remote- or post-conditioning for routine STEMI care.

Commentary: Associate Professor David Eccleston