Late Remote Ischemic Preconditioning Provides Benefit to Patients Undergoing Elective Percutaneous Coronary Intervention
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To assess whether late remote ischemic preconditioning (L-RIPC) is effective in myocardial protection in patients with ischemic heart disease undergoing elective percutaneous coronary intervention (PCI). L-RIPC is exerted by newly synthesized cardioprotective proteins. The cardioprotective effects of L-RIPC are more durable. 200 consecutive patients undergoing elective PCI were randomized to receive L-RIPC (induced by three 5-minute inflations of a blood pressure cuff to 200 mmHg around the upper arm, followed by 5-min intervals of reperfusion) or control (an uninflated cuff around the arm) at 18 h before PCI. Creatine phosphokinase (CK), its cardiac isoenzyme (CK-MB), troponin I (TNI), and high-sensitivity C-reactive protein (hs-CRP) levels were measured at 24 h after PCI. Adverse events’ rates at 6 months were assessed. Compared with the control group, patients in L-RIPC group were observed with significantly lower incidences in Chest pain score >1 and ECG ST deviation >1 mm (P < 0.05). The median TNI, CK, and CK-MB concentrations at 24 h were lower in the L-RIPC group (0.009 vs. 0.036 ng/mL, 123 vs. 186 IU/L, 15 vs. 27 IU/L; P < 0.05). There was no statistical difference in hs-CRP between two groups. At 6 months, the adverse events’ rate was lower in the L-RIPC group (P = 0.036). L-RIPC is effective in myocardial protection in patients undergoing elective PCI and reduces adverse events’ rate at 6 months.
KeywordsLate remote ischemic preconditioning Ischemic heart disease Elective percutaneous coronary intervention Troponin I
Conflict of interest
None of authors have a conflict of interest.
The contents are solely the responsibility of the authors and do not represent the official view of any organization.
- 15.Meybohm, P., Zacharowski, K., Cremer, J., RIP Heart-Study Investigator Group, et al. (2012). Remote ischaemic preconditioning for heart surgery. The study design for a multi-center randomized double-blinded controlled clinical trial—The RIPHeart-Study. European Heart Journal, 33, 1423–1426.PubMedGoogle Scholar
- 17.Wagner, R., Piler, P., Bedanova, H., et al. (2010). Myocardial injury is decreased by late remote ischaemic preconditioning and aggravated by tramadol in patients undergoing cardiac surgery: A randomised controlled trial. Interactive Cardio Vascular and Thoracic Surgery, 11, 758–762.CrossRefGoogle Scholar
- 19.Porto, I., Selvanayagam, J. B., Van Gaal, W. J., et al. (2006). Plaque volume and occurrence and location of periprocedural myocardial necrosis after percutaneous coronary intervention: insights from delayed-enhancement magnetic resonanceimaging, thrombolysis in myocardial infarction myocardial perfusion grade analysis, and intravascular ultrasound. Circulation, 114, 662–669.PubMedCrossRefGoogle Scholar
- 22.Dm, R., Ve, H., Ge, T., et al. (2012). Remote ischemic preconditioning reduces thrombus formation in the rat. The Journal of Thrombosis and Haemostasis, 10, 1538–7836.Google Scholar