title: Remote ischaemic postconditioning: does it protect against ischaemic damage in percutaneous coronary revascularisation? Randomised placebo-controlled clinical trial.
abstract: OBJECTIVE
  Determine whether remote ischaemic postconditioning (RIP) protects against percutaneous coronary intervention-related myocardial infarction (PCI-MI).
  
  
  METHODS
  Single-centre, randomised, blinded to the researchers, clinical trial. ClinicalTrials.gov (NCT 01113008).
  
  
  METHODS
  Tertiary hospital centre.
  
  
  METHODS
  232 patients underwent elective PCI for stable or unstable angina.
  
  
  METHODS
  Patients were randomised to RIP (induction of three 5-min cycles of ischaemia in the arm after the PCI) versus placebo.
  
  
  METHODS
  The primary outcome measure was the peak 24-h troponin I level. PCI-MI was defined by an elevation of troponin values >3 or >5 of the 99th percentile according to the classical or the new definition. The secondary outcome measure was hospital admission, PCI for stable angina or acute coronary syndrome and mortality after 1 year of follow-up. The use of RIP in diabetic patients was specifically studied.
  
  
  RESULTS
  The mean age was 64.6 years, and 42% were diabetic. The peak troponin in the RIP patients was 0.476 vs 0.478 ng/mL (p=0.99). PCI-MI occurred in 36% of the RIP patients versus 30.8% in the placebo group (p=0.378). Diabetic RIP patients had more PCI-MI (new definition): OR 2.7; 95% CI 1.10 to 6.92; p=0.027. The secondary outcome measure was seen in 11.7% of the RIP patients versus 10.8% in the placebo group (p=0.907).
  
  
  CONCLUSIONS
  RIP did not reduce the damage associated with elective PCI or cardiovascular events during the follow-up. The diabetic population who underwent RIP had more PCI-MI.
authors.affiliation: Área del Corazón del Hospital Clínico Universitario Virgen de la Victoria, Fundación IMABIS, RECAVA, Málaga, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Carrasco-Chinchilla
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Muñoz-García
authors.forename: Antonio
authors.initials: A
authors.lastname: Domínguez-Franco
authors.forename: Gloria
authors.initials: G
authors.lastname: Millán-Vázquez
authors.forename: Alicia
authors.initials: A
authors.lastname: Guerrero-Molina
authors.forename: Carmen
authors.initials: C
authors.lastname: Ortiz-García
authors.forename: Alfredo
authors.initials: A
authors.lastname: Enguix-Armada
authors.forename: Juan H
authors.initials: JH
authors.lastname: Alonso-Briales
authors.forename: Jose M
authors.initials: JM
authors.lastname: Hernández-García
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Teresa-Galván
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Jiménez-Navarro
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000628:therapy; D000368:Aged; D060050:Angina, Stable / Q000401:mortality / Q000628:therapy*; D000789:Angina, Unstable / Q000401:mortality / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D057775:Ischemic Postconditioning / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D015428:Myocardial Reperfusion Injury / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016017:Odds Ratio; D010359:Patient Readmission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D015854:Up-Regulation; D034941:Upper Extremity / Q000098:blood supply*
chemical_list: D015415:Biomarkers; D019210:Troponin I