title: Long-term outcome following remote ischemic postconditioning during percutaneous coronary interventions-the RIP-PCI trial long-term follow-up.
abstract: The clinical value of ischemic conditioning during percutaneous coronary intervention (PCI) and mode of administration is controversial. Our aim was to assess the long-term effect of remote ischemic postconditioning among patients undergoing PCI. We randomized 360 patients undergoing PCI who presented with a negative troponin T at baseline into 3 groups: 2 groups received remote ischemic postconditioning (with ischemia applied to the arm in 1 group and to the thigh in the other group), and the third group acted as a control group. Remote ischemic postconditioning was applied during PCI immediately following stent deployment, by 3, 5-minute cycles of blood pressure cuff inflation to >200 mm Hg on the arm or thigh (20 mm Hg to the arm in the control), with 5-minute breaks between each cycle. There were no differences in baseline characteristics among the 3 groups. Periprocedural myocardial injury occurred in 33% (P = 0.64). After 1 year, there was no difference between groups in death (P = 0.91), myocardial infarction (P = 0.78), or repeat revascularization (P = 0.86). During 3 years of follow-up, there was no difference in death, myocardial infarction, and revascularization among the groups (P = 0.45). Remote ischemic postconditioning during PCI did not affect long-term cardiovascular outcome. A similar effect was obtained when remote ischemia was induced to the upper or lower limb. ClinicalTrials.gov Identifier: NCT00970827.
authors.affiliation: Western University, London, Ontario, Canada.|London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Shahar
authors.initials: S
authors.lastname: Lavi
authors.affiliation: London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Nour
authors.initials: N
authors.lastname: Abu-Romeh
authors.affiliation: London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Wall
authors.affiliation: London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Mistre
authors.initials: M
authors.lastname: Alemayehu
authors.affiliation: Western University, London, Ontario, Canada.|London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Ronit
authors.initials: R
authors.lastname: Lavi
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000789:Angina, Unstable / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001132:Arm / Q000098:blood supply*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019194:Ischemic Preconditioning / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D015428:Myocardial Reperfusion Injury / Q000209:etiology; D009864:Ontario; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D015607:Stents; D013848:Thigh / Q000098:blood supply*; D013997:Time Factors; D014111:Tourniquets; D016896:Treatment Outcome
keywords: Cardiac; Clinical trials; catheterization/diagnostic interventional