title: Efficacy of electroacupuncture pretreatment for myocardial injury in patients undergoing percutaneous coronary intervention: A randomized clinical trial with a 2-year follow-up.
abstract: Electroacupuncture pretreatment (EAP) safely protects the heart from ischemic injury, however, the efficacy of EAP for periprocedural myocardial injury after percutaneous coronary intervention (PCI) remains unclear. Our aim was to investigate whether EAP prior to PCI reduces post-PCI myocardial injury in patients with coronary artery disease (CAD). 388 patients (≥ 18 years old) with CAD, undergoing elective PCI were enrolled and randomized, out of those 204 went through the whole trial. EAP was conducted by 30-minute electrical stimulation through 4 electrodes attached to the Antiguan (PC6) and Ximen (PC4) acupoints in the forearm bilaterally 1-2h prior to PCI. The control group had sham electrodes but no electrical stimulation. The primary end point was the incidence of myocardial infarction type 4a (MI4a) based on serum cTnI values at 24h after PCI. The secondary end points included post-procedural cardiac function and the major adverse cardiac/cerebrovascular event (MACCE) rate. EAP prior to PCI significantly reduced the incidence of MI4a (serum cTnI≥0.20 ng/mL) 24h post-PCI compared to the control group (P=0.004). The echocardiography at 6 months after PCI revealed significant improvement in cardiac function in the EAP group compared with the control group. The MACCE rate was significantly decreased in the EAP group at 24 month follow-up compared to the control group (P=0.0157). Moreover, multivariate logistic regression analysis showed that EAP was associated with decreased likelihood of MACCE (odds ratio 0.327, 95% CI 0.140-0.767, P=0.010). EAP prior to PCI significantly reduced cTnI release and protected patients with CAD from subsequent myocardial injury after PCI procedure.
authors.affiliation: Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Liang
authors.affiliation: Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Weijie
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Cardiology, Shenyang PLA General Hospital, Shenyang 110016, China.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
authors.forename: Yaning
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Cardiology, Xi'an Central Hospital, Xi'an 710003, China;
authors.forename: Weichuan
authors.initials: W
authors.lastname: Xin
authors.affiliation: Department of Cardiology, People's Hospital of Qinghai Province, Xining 810007, China.
authors.forename: Baili
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Dongdong
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. Electronic address: fengcao@fmmu.edu.cn.
authors.forename: Feng
authors.initials: F
authors.lastname: Cao
authors.affiliation: Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China. Electronic address: lxiong@fmmu.edu.cn.
authors.forename: Lize
authors.initials: L
authors.lastname: Xiong
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D015671:Electroacupuncture / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D019210:Troponin I / Q000097:blood; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D019210:Troponin I
keywords: Coronary artery disease; Electroacupuncture; Myocardial infarction; Percutaneous coronary intervention; Pretreatment