title: The effects of remote ischemic conditioning in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: a meta-analysis.
abstract: BACKGROUND
  Timely and successful reperfusion is effective at improving outcome in patients presenting with ST elevation myocardial infarction (STEMI). However, abrupt restoration of blood flow may cause detrimental myocardial reperfusion injury. Remote ischemic conditioning (RIC) is a potent activator of innate protection against ischemia-reperfusion injury. This study assessed remote ischemic conditioning in patients presenting with STEMI treated with primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Relevant studies were identified through electronic literature search from PubMed, Medline, EMBASE, CNKI, WANFANG, and VIP. Studies published up to December 2015 were eligible for inclusion. RIC was performed by applying consecutive cycles of reocclusion/reperfusion through intermittent upper or lower limb ischemia before, during, or after reperfusion. The outcomes included creatine kinase-MB (CK-MB), ST resolution (STR), and left ventricular ejection fraction (LVEF).
  
  
  RESULTS
  The 9 trials allocated 540 patients to perform RIC cycles before, during, or after reperfusion and 533 patients to usual PCI. Statistical analysis indicated that the peak of CK-MB and CK-MB AUC in RIC groups decrease significantly during the first 72 hours after PCI compared with controls (P=0.02 and P<0.01). The STR was significantly improved in RIC patients than in control subjects (P<0.001). LVEF is also improved 7 days after myocardial infarction (P=0.001). However, LVEF was not significantly different between study groups over 1 month (P=0.65).
  
  
  CONCLUSIONS
  There may be a cardioprotective effect of RIC before, during, or after reperfusion, in the setting of acute STEMI.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.|Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.|Department of Endocrinology, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.|Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Qingjie
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Bangdang
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.|Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.|Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.|Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Yitong
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China - yangyn5126@163.com.|Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, China.
authors.forename: Yining
authors.initials: Y
authors.lastname: Yang
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome