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Effect of One-Cycle Remote Ischemic Preconditioning to Reduce Myocardial Injury During Percutaneous Coronary Intervention

Up to 1/3 of percutaneous coronary interventions (PCIs) are complicated by troponin release. Remote ischemic preconditioning (IPC) confers effective cardioprotection; however, a 30-minute remote IPC protocol may be difficult to implement during ad hoc PCI. This study was performed to assess the abil... Full description

Journal Title: The American journal of cardiology 2014, Vol.113 (12), p.2013-2017
Main Author: Zografos, Theodoros A., PhD, MSc, MD
Other Authors: Katritsis, George D., MD , Tsiafoutis, Ioannis, MD , Bourboulis, Nikolaos, PhD , Katsivas, Apostolos, PhD , Katritsis, Demosthenes G., PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/24793669
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title: Effect of One-Cycle Remote Ischemic Preconditioning to Reduce Myocardial Injury During Percutaneous Coronary Intervention
format: Article
creator:
  • Zografos, Theodoros A., PhD, MSc, MD
  • Katritsis, George D., MD
  • Tsiafoutis, Ioannis, MD
  • Bourboulis, Nikolaos, PhD
  • Katsivas, Apostolos, PhD
  • Katritsis, Demosthenes G., PhD
subjects:
  • Abridged Index Medicus
  • Aged
  • Analysis
  • Angioplasty, Balloon, Coronary - adverse effects
  • Angioplasty, Balloon, Coronary - methods
  • Biomarkers - blood
  • Blood pressure
  • Cardiac patients
  • Cardiology
  • Cardiovascular
  • Cardiovascular disease
  • Confidence intervals
  • Coronary Angiography - methods
  • Coronary Artery Disease - diagnostic imaging
  • Coronary Artery Disease - mortality
  • Coronary Artery Disease - therapy
  • Coronary heart disease
  • Coronary vessels
  • Female
  • Follow-Up Studies
  • Heart attacks
  • Hospital Mortality - trends
  • Humans
  • Ischemia
  • Ischemic Preconditioning - methods
  • Logistic Models
  • Male
  • Medical imaging
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction - blood
  • Myocardial Infarction - prevention & control
  • Myocardial Reperfusion Injury - blood
  • Myocardial Reperfusion Injury - prevention & control
  • Pain
  • Percutaneous Coronary Intervention - adverse effects
  • Percutaneous Coronary Intervention - methods
  • Pilot Projects
  • Risk Assessment
  • Severity of Illness Index
  • Stents
  • Survival Rate
  • Transluminal angioplasty
  • Treatment Outcome
  • Troponin I - analysis
  • Troponin I - blood
ispartof: The American journal of cardiology, 2014, Vol.113 (12), p.2013-2017
description: Up to 1/3 of percutaneous coronary interventions (PCIs) are complicated by troponin release. Remote ischemic preconditioning (IPC) confers effective cardioprotection; however, a 30-minute remote IPC protocol may be difficult to implement during ad hoc PCI. This study was performed to assess the ability of a brief remote IPC protocol to attenuate cardiac troponin I (cTnI) release after ad hoc PCI. Ninety-four patients undergoing ad hoc PCI for stable coronary artery disease, with undetectable preprocedural cTnI, were recruited and randomized to receive remote IPC (induced by one 5-minute inflation of a blood pressure cuff to 200 mm Hg around the upper arm) or control after the decision for PCI was made. The primary outcome was the difference between cTnI levels 24 hours after PCI and cTnI levels before coronary angiography (ΔcTnI). ΔcTnI in the remote IPC group was significantly lower compared with the control group (0.04 ng/ml [interquartile range 0.01 to 0.14] vs 0.19 ng/ml [interquartile range 0.18 to 0.59], p
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleEffect of One-Cycle Remote Ischemic Preconditioning to Reduce Myocardial Injury During Percutaneous Coronary Intervention
creatorZografos, Theodoros A., PhD, MSc, MD ; Katritsis, George D., MD ; Tsiafoutis, Ioannis, MD ; Bourboulis, Nikolaos, PhD ; Katsivas, Apostolos, PhD ; Katritsis, Demosthenes G., PhD
creatorcontribZografos, Theodoros A., PhD, MSc, MD ; Katritsis, George D., MD ; Tsiafoutis, Ioannis, MD ; Bourboulis, Nikolaos, PhD ; Katsivas, Apostolos, PhD ; Katritsis, Demosthenes G., PhD
descriptionUp to 1/3 of percutaneous coronary interventions (PCIs) are complicated by troponin release. Remote ischemic preconditioning (IPC) confers effective cardioprotection; however, a 30-minute remote IPC protocol may be difficult to implement during ad hoc PCI. This study was performed to assess the ability of a brief remote IPC protocol to attenuate cardiac troponin I (cTnI) release after ad hoc PCI. Ninety-four patients undergoing ad hoc PCI for stable coronary artery disease, with undetectable preprocedural cTnI, were recruited and randomized to receive remote IPC (induced by one 5-minute inflation of a blood pressure cuff to 200 mm Hg around the upper arm) or control after the decision for PCI was made. The primary outcome was the difference between cTnI levels 24 hours after PCI and cTnI levels before coronary angiography (ΔcTnI). ΔcTnI in the remote IPC group was significantly lower compared with the control group (0.04 ng/ml [interquartile range 0.01 to 0.14] vs 0.19 ng/ml [interquartile range 0.18 to 0.59], p <0.001). The incidence of PCI-related myocardial infarction (MI) was greater in the control group (42.6% vs 19.1%, p = 0.014). In multivariate analysis, remote IPC was independently associated with ΔcTnI and PCI-related MI. In conclusion, our results suggest that even 1 cycle of remote IPC immediately before ad hoc PCI attenuates periprocedural cTnI release and reduces the incidence of type 4a MI.
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subjectAbridged Index Medicus ; Aged ; Analysis ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - methods ; Biomarkers - blood ; Blood pressure ; Cardiac patients ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Confidence intervals ; Coronary Angiography - methods ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary Artery Disease - therapy ; Coronary heart disease ; Coronary vessels ; Female ; Follow-Up Studies ; Heart attacks ; Hospital Mortality - trends ; Humans ; Ischemia ; Ischemic Preconditioning - methods ; Logistic Models ; Male ; Medical imaging ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction - blood ; Myocardial Infarction - prevention & control ; Myocardial Reperfusion Injury - blood ; Myocardial Reperfusion Injury - prevention & control ; Pain ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - methods ; Pilot Projects ; Risk Assessment ; Severity of Illness Index ; Stents ; Survival Rate ; Transluminal angioplasty ; Treatment Outcome ; Troponin I - analysis ; Troponin I - blood
ispartofThe American journal of cardiology, 2014, Vol.113 (12), p.2013-2017
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4Katsivas, Apostolos, PhD
5Katritsis, Demosthenes G., PhD
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descriptionUp to 1/3 of percutaneous coronary interventions (PCIs) are complicated by troponin release. Remote ischemic preconditioning (IPC) confers effective cardioprotection; however, a 30-minute remote IPC protocol may be difficult to implement during ad hoc PCI. This study was performed to assess the ability of a brief remote IPC protocol to attenuate cardiac troponin I (cTnI) release after ad hoc PCI. Ninety-four patients undergoing ad hoc PCI for stable coronary artery disease, with undetectable preprocedural cTnI, were recruited and randomized to receive remote IPC (induced by one 5-minute inflation of a blood pressure cuff to 200 mm Hg around the upper arm) or control after the decision for PCI was made. The primary outcome was the difference between cTnI levels 24 hours after PCI and cTnI levels before coronary angiography (ΔcTnI). ΔcTnI in the remote IPC group was significantly lower compared with the control group (0.04 ng/ml [interquartile range 0.01 to 0.14] vs 0.19 ng/ml [interquartile range 0.18 to 0.59], p <0.001). The incidence of PCI-related myocardial infarction (MI) was greater in the control group (42.6% vs 19.1%, p = 0.014). In multivariate analysis, remote IPC was independently associated with ΔcTnI and PCI-related MI. In conclusion, our results suggest that even 1 cycle of remote IPC immediately before ad hoc PCI attenuates periprocedural cTnI release and reduces the incidence of type 4a MI.
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2Analysis
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10Cardiovascular disease
11Confidence intervals
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13Coronary Artery Disease - diagnostic imaging
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25Logistic Models
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29Multivariate Analysis
30Myocardial Infarction - blood
31Myocardial Infarction - prevention & control
32Myocardial Reperfusion Injury - blood
33Myocardial Reperfusion Injury - prevention & control
34Pain
35Percutaneous Coronary Intervention - adverse effects
36Percutaneous Coronary Intervention - methods
37Pilot Projects
38Risk Assessment
39Severity of Illness Index
40Stents
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42Transluminal angioplasty
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45Troponin I - blood
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2Analysis
3Angioplasty, Balloon, Coronary - adverse effects
4Angioplasty, Balloon, Coronary - methods
5Biomarkers - blood
6Blood pressure
7Cardiac patients
8Cardiology
9Cardiovascular
10Cardiovascular disease
11Confidence intervals
12Coronary Angiography - methods
13Coronary Artery Disease - diagnostic imaging
14Coronary Artery Disease - mortality
15Coronary Artery Disease - therapy
16Coronary heart disease
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19Follow-Up Studies
20Heart attacks
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31Myocardial Infarction - prevention & control
32Myocardial Reperfusion Injury - blood
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34Pain
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36Percutaneous Coronary Intervention - methods
37Pilot Projects
38Risk Assessment
39Severity of Illness Index
40Stents
41Survival Rate
42Transluminal angioplasty
43Treatment Outcome
44Troponin I - analysis
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abstractUp to 1/3 of percutaneous coronary interventions (PCIs) are complicated by troponin release. Remote ischemic preconditioning (IPC) confers effective cardioprotection; however, a 30-minute remote IPC protocol may be difficult to implement during ad hoc PCI. This study was performed to assess the ability of a brief remote IPC protocol to attenuate cardiac troponin I (cTnI) release after ad hoc PCI. Ninety-four patients undergoing ad hoc PCI for stable coronary artery disease, with undetectable preprocedural cTnI, were recruited and randomized to receive remote IPC (induced by one 5-minute inflation of a blood pressure cuff to 200 mm Hg around the upper arm) or control after the decision for PCI was made. The primary outcome was the difference between cTnI levels 24 hours after PCI and cTnI levels before coronary angiography (ΔcTnI). ΔcTnI in the remote IPC group was significantly lower compared with the control group (0.04 ng/ml [interquartile range 0.01 to 0.14] vs 0.19 ng/ml [interquartile range 0.18 to 0.59], p <0.001). The incidence of PCI-related myocardial infarction (MI) was greater in the control group (42.6% vs 19.1%, p = 0.014). In multivariate analysis, remote IPC was independently associated with ΔcTnI and PCI-related MI. In conclusion, our results suggest that even 1 cycle of remote IPC immediately before ad hoc PCI attenuates periprocedural cTnI release and reduces the incidence of type 4a MI.
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