title: Effect of remote ischemic preconditioning on serum troponin T level following elective percutaneous coronary intervention.
abstract: BACKGROUND
  Elective percutaneous coronary intervention (PCI) is associated with myocardial necrosis, as evidenced by troponin release, in approximately one-third of cases. This is known to be linked with subsequent cardiovascular events. This study assessed the ability of remote ischemic preconditioning (RIPC) to attenuate cardiac troponin T (cTnT) release after elective PCI.
  
  
  OBJECTIVE
  Evaluation of effect of RIPC on myocardial markers following elective PCI.
  
  
  METHODS
  One hundred and forty nine consecutive patients undergoing elective PCI with undetectable preprocedural cTnT were recruited. Subjects were randomized to receive RIPC (induced by three 5-min inflations of a blood pressure cuff to 200 mm Hg around the upper arm, followed by 5-min intervals of reperfusion) or control (cuff deflated) immediately before arrival in the cardiac catheterization room. The primary outcome was cTnT level at approximately 16 hr after PCI. Secondary outcomes included occurrence of postprocedural myocardial infarction (MI), CKMB levels at 16 hr after PCI and assessment of the inflammatory response as measured by C-reactive protein (CRP) levels.
  
  
  RESULTS
  The mean cTnT at 16 hr after PCI was lower in the RIPC group compared with the control group. (0.020 vs. 0.047 ng/ml; P = 0.047) Occurrence of postprocedural MI, CKMB and CRP levels did not differ in both groups (P = 0.097, 0.537, and 0.481 respectively).
  
  
  CONCLUSIONS
  The use of RIPC immediately prior to PCI attenuates procedure-related cTnT release and does not affect occurrence of post procedural MI, CKMB, or CRP levels.
authors: Cardiovascular Medicine Department, Dar Al-Fouad Hospital, Giza, Egypt and Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; Internal Medicine Department, Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan; Detroit Medical Center, Cardiovascular Institute, Wayne State University School of Medicine, Detroit, Michigan.
authors: Rashed M
authors: RM
authors: Ahmed
authors: El-Haddad A
authors: el-HA
authors: Mohamed
authors: Mostafa
authors: M
authors: Ashraf
authors: Shenoy
authors: S
authors: Maithili
authors: Farag
authors: F
authors: Nabil
authors: Raymond
authors: R
authors: Rami
authors: Tahir I
authors: TI
authors: Mohamed
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D052279:Creatine Kinase, MB Form / Q000097:blood; D004534:Egypt; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D019194:Ischemic Preconditioning / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*; D034941:Upper Extremity / Q000098:blood supply*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; C545568:TNNT2 protein, human; D020107:Troponin T; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form
keywords: percutaneous coronary intervention; remote ischemic preconditioning; troponin