title: Remote ischemic postconditioning: does it protect against ischemic damage in percutaneous coronary revascularization? justification and design of a randomized placebo-controlled clinical trial.
abstract: OBJECTIVE
  Myocardial damage that is associated with percutaneous coronary intervention (PCI) partially affects the results of the procedure, and is related to medium-term cardiovascular death. Remote postischemic conditioning might reduce the myocardial lesions that are associated with PCI, but perhaps less so in diabetics. The aim of this study was to evaluate the protective effect of remote postischemic conditioning in patients undergoing elective PCI for stable angina or non-ST elevation acute coronary syndrome with troponin <1 ng/ml at the time of randomization.
  
  
  METHODS
  This randomized single-blinded single-center clinical trial involved 320 patients undergoing elective PCI who were randomized to either receive three 5-min cycles of ischemia by inflation of a cuff on the non-dominant arm to 200 mm Hg (remote postischemic conditioning) or to placebo (uninflated cuff). The primary outcome variable was the maximum increase in troponin in the first 24 h. The secondary outcome variable was readmission due to heart failure or cardiovascular mortality after 1 year of follow-up. In addition, a diabetic population was studied.
  
  
  CONCLUSIONS
  This clinical trial evaluated the possible reduction in intervention-related myocardial damage that was attributable to remote postischemic conditioning.
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. fernandocarrascochinchilla@gmail.com
authors.forename: M F
authors.initials: MF
authors.lastname: Jiménez-Navarro
authors.forename: F
authors.initials: F
authors.lastname: Carrasco-Chinchilla
authors.forename: A J
authors.initials: AJ
authors.lastname: Muñoz-García
authors.forename: A
authors.initials: A
authors.lastname: Domínguez-Franco
authors.forename: J
authors.initials: J
authors.lastname: Caballero-Borrego
authors.forename: J H
authors.initials: JH
authors.lastname: Alonso-Briales
authors.forename: J M
authors.initials: JM
authors.lastname: Hernández-García
authors.forename: E
authors.initials: E
authors.lastname: de Teresa-Galván
mesh_terms: D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D016001:Confidence Intervals; D017023:Coronary Angiography / Q000379:methods; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D057775:Ischemic Postconditioning / Q000379:methods*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017202:Myocardial Ischemia / Q000517:prevention & control*; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016019:Survival Analysis; D016896:Treatment Outcome