Skip to main content
SpringerLink
Log in

Postconditioning attenuates no-reflow in STEMI patients

  • Original Contribution
  • Published:
Basic Research in Cardiology Aims and scope Submit manuscript

An Editorial to this article was published on 11 September 2013

Abstract

After acute myocardial infarction, the presence of no-reflow (or microvascular obstruction: MVO) has been associated with adverse left ventricular (LV) remodeling and worse clinical outcome. This study examined the effects of mechanical ischemic postconditioning on early and late MVO size in acute ST-elevation myocardial infarction (STEMI) patients. Fifty patients undergoing primary coronary angioplasty for a first STEMI with TIMI grade flow 0–1 and no collaterals were randomized to ischemic postconditioning (PC) (n = 25) or control (n = 25) groups. Ischemic PC consisted in the application of four consecutive cycles of a 1-min balloon occlusion, each followed by a 1-min deflation at the onset of reperfusion. Early (3 min post-contrast) and late (10 min post-contrast) MVO size were assessed by contrast-enhanced cardiac-MRI within 96 h after reperfusion. PC was associated with smaller early and late MVO size (3.9 ± 4.8 in PC versus 7.8 ± 6.6 % of LV in controls for early MVO, P = 0.02; and 1.8 ± 3.1 in PC versus 4.1 ± 3.9 % of LV in controls for late MVO; P = 0.01). This significant reduction was persistent after adjustment for thrombus aspiration, which neither had any significant effect on infarct size, nor on early or late MVO (P = NS for all). Attenuation of MVO was associated to infarct size reduction. Mechanical postconditioning significantly reduces MVO in patients with acute STEMI treated with primary angioplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Albert TS, Kim RJ, Judd RM (2006) Assessment of no-reflow regions using cardiac MRI. Basic Res Cardiol 101:383–390. doi:10.1007/s00395-006-0617-0

    Article  PubMed  Google Scholar 

  2. Argaud L, Gateau-Roesch O, Raisky O, Loufouat J, Robert D, Ovize M (2005) Postconditioning inhibits mitochondrial permeability transition. Circulation 111:194–197. doi:10.1161/01.CIR.0000151290.04952.3B

    Article  PubMed  CAS  Google Scholar 

  3. Feild BJ, Russell ROJ, Dowling JT, Rackley CE (1972) Regional left ventricular performance in the year following myocardial infarction. Circulation 46:679–689

    Article  PubMed  CAS  Google Scholar 

  4. Freixa X, Bellera N, Ortiz-Perez JT, Jimenez M, Pare C, Bosch X, De Caralt TM, Betriu A, Masotti M (2012) Ischaemic postconditioning revisited: lack of effects on infarct size following primary percutaneous coronary intervention. Eur Heart J 33:103–112. doi:10.1093/eurheartj/ehr297

    Article  PubMed  Google Scholar 

  5. Ganame J, Messalli G, Dymarkowski S, Rademakers FE, Desmet W, Van de Werf F, Bogaert J (2009) Impact of myocardial haemorrhage on left ventricular function and remodelling in patients with reperfused acute myocardial infarction. Eur Heart J 30:1440–1449. doi:10.1093/eurheartj/ehp093

    Article  PubMed  Google Scholar 

  6. Garcia S, Henry TD, Wang YL, Chavez IJ, Pedersen WR, Lesser JR, Shroff GR, Moore L, Traverse JH (2011) Long-term follow-up of patients undergoing postconditioning during ST-elevation myocardial infarction. J Cardiovasc Transl Res 4:92–98. doi:10.1007/s12265-010-9252-0

    Article  PubMed  Google Scholar 

  7. Heusch G (2004) Postconditioning: old wine in a new bottle? J Am Coll Cardiol 44:1111–1112. doi:10.1016/j.jacc.2004.06.013

    Article  PubMed  Google Scholar 

  8. Heusch G, Kleinbongard P, Bose D, Levkau B, Haude M, Schulz R, Erbel R (2009) Coronary microembolization: from bedside to bench and back to bedside. Circulation 120:1822–1836. doi:10.1161/CIRCULATIONAHA.109.888784

    Article  PubMed  Google Scholar 

  9. Heusch G, Schulz R (2011) Preservation of peripheral vasodilation as a surrogate of cardioprotection? The mechanistic role of ATP-dependent potassium channels and the mitochondrial permeability transition pore. Eur Heart J 32:1184–1186. doi:10.1093/eurheartj/ehq511

    Article  PubMed  Google Scholar 

  10. Heusch G, Musiolik J, Gedik N, Skyschally A (2011) Mitochondrial STAT3 activation and cardioprotection by ischemic postconditioning in pigs with regional myocardial ischemia/reperfusion. Circ Res 109:1302–1308. doi:10.1161/CIRCRESAHA.111.255604

    Article  PubMed  CAS  Google Scholar 

  11. Heusch G, Kleinbongard P, Skyschally A, Levkau B, Schulz R, Erbel R (2012) The coronary circulation in cardioprotection: more than just one confounder. Cardiovasc Res 94:237–245. doi:10.1093/cvr/cvr271

    Article  PubMed  CAS  Google Scholar 

  12. Heusch G (2013) Cardioprotection: chances and challenges of its translation to the clinic. Lancet 381:166–175. doi:10.1016/S0140-6736(12)60916-7

    Article  PubMed  Google Scholar 

  13. Kaltoft A, Bottcher M, Nielsen SS, Hansen HH, Terkelsen C, Maeng M, Kristensen J, Thuesen L, Krusell LR, Kristensen SD, Andersen HR, Lassen JF, Rasmussen K, Rehling M, Nielsen TT, Botker HE (2006) Routine thrombectomy in percutaneous coronary intervention for acute ST-segment-elevation myocardial infarction: a randomized, controlled trial. Circulation 114:40–47. doi:10.1161/CIRCULATIONAHA.105.595660

    Article  PubMed  Google Scholar 

  14. Kin H, Zhao ZQ, Sun HY, Wang NP, Corvera JS, Halkos ME, Kerendi F, Guyton RA, Vinten-Johansen J (2004) Postconditioning attenuates myocardial ischemia-reperfusion injury by inhibiting events in the early minutes of reperfusion. Cardiovasc Res 62:74–85. doi:1016/j.cardiores.2004.01.006

    Article  PubMed  CAS  Google Scholar 

  15. Kloner RA, Ganote CE, Jennings RB (1974) The “no-reflow” phenomenon after temporary coronary occlusion in the dog. J Clin Invest 54:1496–1508. doi:10.1172/JCI107898

    Article  PubMed  CAS  Google Scholar 

  16. Lapeyre ACr, St Gibson W, Bashore TM, Gibbons RJ (2003) Quantitative regional wall motion analysis with early contrast ventriculography for the assessment of myocardium at risk in acute myocardial infarction. Am Heart J 145:1051–1057. doi:10.1016/S0002-8703(03)00112-1

    Article  PubMed  Google Scholar 

  17. Liistro F, Grotti S, Angioli P, Falsini G, Ducci K, Baldassarre S, Sabini A, Brandini R, Capati E, Bolognese L (2009) Impact of thrombus aspiration on myocardial tissue reperfusion and left ventricular functional recovery and remodeling after primary angioplasty. Circ Cardiovasc Interv 2:376–383. doi:10.1161/CIRCINTERVENTIONS.109.852665

    Article  PubMed  Google Scholar 

  18. Lipiecki J, Monzy S, Durel N, Cachin F, Chabrot P, Muliez A, Morand D, Maublant J, Ponsonnaille J (2009) Effect of thrombus aspiration on infarct size and left ventricular function in high-risk patients with acute myocardial infarction treated by percutaneous coronary intervention. Results of a prospective controlled pilot study. Am Heart J 157:583.e1–583.e7. doi:10.1016/j.ahj.2008.11.017

    Article  Google Scholar 

  19. Lonborg J, Kelbaek H, Vejlstrup N, Jorgensen E, Helqvist S, Saunamaki K, Clemmensen P, Holmvang L, Treiman M, Jensen JS, Engstrom T (2010) Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance. Circ Cardiovasc Interv 3:34–41. doi:10.1161/CIRCINTERVENTIONS.109.905521

    Article  PubMed  Google Scholar 

  20. Mangiacapra F, Wijns W, De Luca G, Muller O, Trana C, Ntalianis A, Heyndrickx G, Vanderheyden M, Bartunek J, De Bruyne B, Barbato E (2010) Thrombus aspiration in primary percutaneous coronary intervention in high-risk patients with ST-elevation myocardial infarction: a real-world registry. Catheter Cardiovasc Interv 76:70–76. doi:10.1002/ccd.22465

    Article  PubMed  Google Scholar 

  21. Mewton N, Rapacchi S, Augeul L, Ferrera R, Loufouat J, Boussel L, Micolich A, Rioufol G, Revel D, Ovize M, Croisille P (2011) Determination of the myocardial area at risk with pre- versus post-reperfusion imaging techniques in the pig model. Basic Res Cardiol. doi:10.1007/s00395-011-0214-8

    PubMed  Google Scholar 

  22. Mongeon FP, Belisle P, Joseph L, Eisenberg MJ, Rinfret S (2010) Adjunctive thrombectomy for acute myocardial infarction: a bayesian meta-analysis. Circ Cardiovasc Interv 3:6–16. doi:10.1161/CIRCINTERVENTIONS.109.904037

    Article  PubMed  Google Scholar 

  23. Nijveldt R, Beek AM, Hirsch A, Stoel MG, Hofman MB, Umans VA, Algra PR, Twisk JW, van Rossum AC (2008) Functional recovery after acute myocardial infarction: comparison between angiography, electrocardiography, and cardiovascular magnetic resonance measures of microvascular injury. J Am Coll Cardiol 52:181–189. doi:10.1016/j.jacc.2008.04.006

    Article  PubMed  Google Scholar 

  24. Nijveldt R, Hofman MB, Hirsch A, Beek AM, Umans VA, Algra PR, Piek JJ, van Rossum AC (2009) Assessment of microvascular obstruction and prediction of short-term remodeling after acute myocardial infarction: cardiac MR imaging study. Radiology 250:363–370. doi:10.1148/radiol.2502080739

    Article  PubMed  Google Scholar 

  25. Okorie MI, Bhavsar DD, Ridout D, Charakida M, Deanfield JE, Loukogeorgakis SP, MacAllister RJ (2011) Postconditioning protects against human endothelial ischaemia-reperfusion injury via subtype-specific KATP channel activation and is mimicked by inhibition of the mitochondrial permeability transition pore. Eur Heart J 32:1266–1274. doi:10.1093/eurheartj/ehr041

    Article  PubMed  CAS  Google Scholar 

  26. Puymirat E, Simon T, Steg PG, Schiele F, Gueret P, Blanchard D, Khalife K, Goldstein P, Cattan S, Vaur L, Cambou JP, Ferrieres J, Danchin N (2012) Association of changes in clinical characteristics and management with improvement in survival among patients with ST-elevation myocardial infarction. JAMA 308:998–1006. doi:10.1001/2012.jama.11348

    Article  PubMed  CAS  Google Scholar 

  27. Robbers LF, Eerenberg ES, Teunissen PF, Jansen MF, Hollander MR, Horrevoets AJ, Knaapen P, Nijveldt R, Heymans MW, Levi MM, van Rossum AC, Niessen HW, Marcu CB, Beek AM, van Royen N (2013) Magnetic resonance imaging-defined areas of microvascular obstruction after acute myocardial infarction represent microvascular destruction and haemorrhage. Eur Heart J 34:2346–2353. doi:10.1093/eurheartj/eht100

    Article  PubMed  CAS  Google Scholar 

  28. Rochitte CE, Lima JA, Bluemke DA, Reeder SB, McVeigh ER, Furuta T, Becker LC, Melin JA (1998) Magnitude and time course of microvascular obstruction and tissue injury after acute myocardial infarction. Circulation 98:1006–1014. doi:10.1161/01.CIR.98.10.1006

    Article  PubMed  CAS  Google Scholar 

  29. Roubille F, Lairez O, Mewton N, Rioufol G, Ranc S, Sanchez I, Cung TT, Elbaz M, Piot C, Ovize M (2012) Cardioprotection by clopidogrel in acute ST-elevated myocardial infarction patients: a retrospective analysis. Basic Res Cardiol 107:275. doi:10.1007/s00395-012-0275-3

    Article  PubMed  Google Scholar 

  30. Sardella G, Mancone M, Bucciarelli-Ducci C, Agati L, Scardala R, Carbone I, Francone M, Di Roma A, Benedetti G, Conti G, Fedele F (2009) Thrombus aspiration during primary percutaneous coronary intervention improves myocardial reperfusion and reduces infarct size: the EXPIRA (thrombectomy with export catheter in infarct-related artery during primary percutaneous coronary intervention) prospective, randomized trial. J Am Coll Cardiol 53:309–315. doi:10.1016/j.jacc.2008.10.017

    Article  PubMed  Google Scholar 

  31. Schwartz BG, Kloner RA (2012) Coronary no reflow. J Mol Cell Cardiol 52:873–882. doi:10.1016/j.yjmcc.2011.06.009

    Article  PubMed  CAS  Google Scholar 

  32. Skyschally A, Leineweber K, Gres P, Haude M, Erbel R, Heusch G (2006) Coronary microembolization. Basic Res Cardiol 101:373–382. doi:10.1007/s00395-006-0616-1

    Article  PubMed  Google Scholar 

  33. Skyschally A, Walter B, Heusch G (2012) Coronary microembolization during early reperfusion: infarct extension, but protection by ischaemic postconditioning. Eur Heart J. doi:10.1093/eurheartj/ehs434

    PubMed  Google Scholar 

  34. Sorensson P, Saleh N, Bouvier F, Bohm F, Settergren M, Caidahl K, Tornvall P, Arheden H, Ryden L, Pernow J (2010) Effect of postconditioning on infarct size in patients with ST elevation myocardial infarction. Heart 96:1710–1715. doi:10.1136/hrt.2010.199430

    Article  PubMed  Google Scholar 

  35. Staat P, Rioufol G, Piot C, Cottin Y, Cung TT, L’Huillier I, Aupetit JF, Bonnefoy E, Finet G, Andre-Fouet X, Ovize M (2005) Postconditioning the human heart. Circulation 112:2143–2148. doi:10.1161/CIRCULATIONAHA.105.558122

    Article  PubMed  Google Scholar 

  36. Steg PG, James SK, Atar D, Badano LP, Lundqvist CB, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K, Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, Van’t Hof A, Widimsky P, Zahger D, Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Hasdai D, Astin F, Astrom-Olsson K, Budaj A, Clemmensen P, Collet JP, Fox KA, Fuat A, Gustiene O, Hamm CW, Kala P, Lancellotti P, Maggioni AP, Merkely B, Neumann FJ, Piepoli MF, Van de Werf F, Verheugt F, Wallentin L (2012) ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J 33:2569–2619. doi:10.1093/eurheartj/ehs215

    Article  PubMed  CAS  Google Scholar 

  37. Stone GW, Maehara A, Witzenbichler B, Godlewski J, Parise H, Dambrink JH, Ochala A, Carlton TW, Cristea E, Wolff SD, Brener SJ, Chowdhary S, El-Omar M, Neunteufl T, Metzger DC, Karwoski T, Dizon JM, Mehran R, Gibson CM (2012) Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction: the INFUSE-AMI randomized trial. JAMA 307:1817–1826. doi:10.1001/jama.2012.421

    Article  PubMed  CAS  Google Scholar 

  38. Sun HY, Wang NP, Kerendi F, Halkos M, Kin H, Guyton RA, Vinten-Johansen J, Zhao ZQ (2005) Hypoxic postconditioning reduces cardiomyocyte loss by inhibiting ROS generation and intracellular Ca2+overload. Am J Physiol Heart Circ Physiol 288:H1900–H1908. doi:10.1152/ajpheart.01244.2003

    Article  PubMed  CAS  Google Scholar 

  39. Svilaas T, Vlaar PJ, van der Horst IC, Diercks GF, de Smet BJ, van den Heuvel AF, Anthonio RL, Jessurun GA, Tan ES, Suurmeijer AJ, Zijlstra F (2008) Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med 358:557–567. doi:10.1056/NEJMoa0706416

    Article  PubMed  CAS  Google Scholar 

  40. Thibault H, Piot C, Staat P, Bontemps L, Sportouch C, Rioufol G, Cung TT, Bonnefoy E, Angoulvant D, Aupetit JF, Finet G, Andre-Fouet X, Macia JC, Raczka F, Rossi R, Itti R, Kirkorian G, Derumeaux G, Ovize M (2008) Long-term benefit of postconditioning. Circulation 117:1037–1044. doi:10.1161/CIRCULATIONAHA.107.729780

    Article  PubMed  CAS  Google Scholar 

  41. Thuny F, Lairez O, Roubille F, Mewton N, Rioufol G, Sportouch C, Sanchez I, Bergerot C, Thibault H, Cung TT, Finet G, Argaud L, Revel D, Derumeaux G, Bonnefoy-Cudraz E, Elbaz M, Piot C, Ovize M, Croisille P (2012) Post-conditioning reduces infarct size and edema in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol 59:2175–2181. doi:10.1016/j.jacc.2012.03.026

    Article  PubMed  Google Scholar 

  42. Vlaar PJ, Svilaas T, van der Horst IC, Diercks GF, Fokkema ML, de Smet BJ, van den Heuvel AF, Anthonio RL, Jessurun GA, Tan ES, Suurmeijer AJ, Zijlstra F (2008) Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study. Lancet 371:1915–1920. doi:10.1016/S0140-6736(08)60833-8

    Article  PubMed  Google Scholar 

  43. Wu KC, Zerhouni EA, Judd RM, Lugo-Olivieri CH, Barouch LA, Schulman SP, Blumenthal RS, Lima JA (1998) Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction. Circulation 97:765–772. doi:10.1161/01.CIR.97.8.765

    Article  PubMed  CAS  Google Scholar 

  44. Wu KC, Kim RJ, Bluemke DA, Rochitte CE, Zerhouni EA, Becker LC, Lima JA (1998) Quantification and time course of microvascular obstruction by contrast-enhanced echocardiography and magnetic resonance imaging following acute myocardial infarction and reperfusion. J Am Coll Cardiol 32:1756–1764. doi:10.1016/S0735-1097(98)00429-X

    Article  PubMed  CAS  Google Scholar 

  45. Yang XM, Proctor JB, Cui L, Krieg T, Downey JM, Cohen MV (2004) Multiple, brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways. J Am Coll Cardiol 44:1103–1110. doi:10.1016/j.jacc.2004.05.060

    Article  PubMed  Google Scholar 

  46. Zhao ZQ, Corvera JS, Halkos ME, Kerendi F, Wang NP, Guyton RA, Vinten-Johansen J (2003) Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning. Am J Physiol Heart Circ Physiol 285:H579–H588. doi:10.1152/ajpheart.01064.2002

    PubMed  CAS  Google Scholar 

  47. Zia MI, Ghugre NR, Connelly KA, Joshi SB, Strauss BH, Cohen EA, Wright GA, Dick AJ (2012) Thrombus aspiration during primary percutaneous coronary intervention is associated with reduced myocardial edema, hemorrhage, microvascular obstruction and left ventricular remodeling. J Cardiovasc Magn Reson 14:19. doi:10.1186/1532-429X-14-19

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to express their sincere acknowledgements to all the research coordinators, nurses and catheterization laboratory staff in the different centers for their help on the screening, enrollment and data collection of participants. This project was supported by a research grant from the Hospices Civils de Lyon (Appel d’Offre HCL Actions Incitatives 2007). Dr. Hélène Thibault was supported by a joint research grant from the French Federation of Cardiology and the French Society of Cardiology (Dotations de Recherche Communes) for this project.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Cardiology Division, Centre d’Investigation Clinique de Lyon (CIC), Groupement Hospitalier Est, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 avenue Doyen Lépine, 69677, Bron, France

    Nathan Mewton, Hélène Thibault, Gilles Rioufol, Ingrid Sanchez, Cyrille Bergerot, Gérard Finet, Eric Bonnefoy-Cudraz, Inesse Sahraoui & Michel Ovize

  2. Service de Cardiologie, Hôpital Rangueil, Université Paul Sabatier, Toulouse, France

    Olivier Lairez & Meyer Elbaz

  3. INSERM U661, Montpellier, France

    François Roubille, Catherine Sportouch, Thien Tri Cung & Christophe Piot

  4. Hôpital Arnaud de Villeneuve, Université de Montpellier I and II, Montpellier, France

    François Roubille, Catherine Sportouch, Thien Tri Cung & Christophe Piot

  5. INSERM UMR-1060, CarMeN Laboratory, Faculté de Médecine Lyon Est, Université Claude Bernard Lyon1, 69373, Lyon, France

    Nathan Mewton, Hélène Thibault & Michel Ovize

  6. CREATIS-LRMN, CNRS UMR 5220, INSERM U630, Université Claude Bernard Lyon 1, Villeurbanne, France

    Nathan Mewton, Ingrid Sanchez, Didier Revel & Pierre Croisille

  7. Centre Hospitalier Universitaire de Tours, Hôpital Trousseau, Université François Rabelais, Tours, France

    Denis Angoulvant

  8. Hôpital Louis Pradel, 59 Bd Pinel, 69394, Lyon Cedex 03, France

    Nathan Mewton

Authors
  1. Nathan Mewton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hélène Thibault
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. François Roubille
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Olivier Lairez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gilles Rioufol
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Catherine Sportouch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ingrid Sanchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cyrille Bergerot
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Thien Tri Cung
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gérard Finet
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Denis Angoulvant
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Didier Revel
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Eric Bonnefoy-Cudraz
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Meyer Elbaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Christophe Piot
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Inesse Sahraoui
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Pierre Croisille
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Michel Ovize
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nathan Mewton.

Additional information

To this article an Editorial is available at doi:10.1007/s00395-013-0380-y.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mewton, N., Thibault, H., Roubille, F. et al. Postconditioning attenuates no-reflow in STEMI patients. Basic Res Cardiol 108, 383 (2013). https://doi.org/10.1007/s00395-013-0383-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00395-013-0383-8

Keywords

Search

Navigation