AI Article Synopsis
- The study explores how remote ischemic preconditioning (RIPC) could protect against myocardial necrosis during elective percutaneous coronary intervention (PCI) in patients with normal baseline troponin levels.
- 205 participants were divided into two groups: one received RIPC before stent implantation and the other did not, with the RIPC group showing significantly lower levels of high sensitive cardiac troponin I (hscTnI) and a reduced incidence of myocardial infarction (MI).
- Ultimately, the findings suggest that RIPC effectively lowers post-PCI TnI release and MI rates, which could have implications for improving patient outcomes following elective coronary procedures.
Article Abstract
Background: Myocardial necrosis occurs frequently in elective percutaneous coronary intervention (PCI) and is associated with subsequent major adverse cardiovascular events (MACEs). This study assessed the protective effect of remote ischemic preconditioning (RIPC) in patients undergoing successful drug-eluting stent implantation with normal baseline troponin values.
Methods: We analyzed 205 participants with normal baseline troponin values undergoing successful coronary stent implantation. Subjects were randomized to 2 groups: The RIPC group (n = 101), whose members received RIPC (created by three 5-minute inflations of a pneumatic medical tourniquet cuff to 200 mm Hg around the upper arm, interspersed with 5-minute intervals of reperfusion) < 2 hours before the PCI procedure, and the control group (n = 104).
Results: The primary outcomes were high sensitive cardiac troponin I (hscTnI) levels and incidence of myocardial infarction (MI 4a, defined as hscTnI > 0.20 ng/mL) at 16 hours after the PCI procedure. The median hscTnI at 16 hours after PCI was lower in the RIPC group compared with the unpreconditioned, control group (0.11 vs 0.21 ng/mL; P < 0.01). The incidence of MI 4a was lower in the RIPC group compared with the control group (39% vs 54%, P < 0.05). Index of renal function showed no difference between the 2 groups at 16 hours after PCI (P > 0.05).
Conclusion: RIPC reduced post-PCI TnI release and incidence of MI 4a in patients undergoing elective coronary stent implantation.
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| http://dx.doi.org/10.1016/j.cjca.2012.11.022 | DOI Listing |
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