title: Remote ischemic preconditioning reduces myocardial injury in patients undergoing coronary stent implantation.
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).
  
  
  CONCLUSIONS
  RIPC reduced post-PCI TnI release and incidence of MI 4a in patients undergoing elective coronary stent implantation.
authors: Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China.
authors: Sheng Jie
authors: SJ
authors: Luo
authors: Yu Jie
authors: YJ
authors: Zhou
authors: Dong Mei
authors: DM
authors: Shi
authors: Hai Long
authors: HL
authors: Ge
authors: Jian Long
authors: JL
authors: Wang
authors: Rui Fang
authors: RF
authors: Liu
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I