The impact of a single episode of remote ischemic preconditioning on myocardial injury after elective percutaneous coronary intervention.
BACKGROUND
Myocardial injury after percutaneous coronary intervention (PCI) occurs in approximately 30% of procedures, and is related to worse prognosis. Effects of remote ischemic preconditioning (RIPC) on reperfusion injury have been investigated before, yielding conflicting results.


OBJECTIVE
To assess the impact of a single episode of RIPC on myocardial injury after elective PCI.


METHODS
One hundred and four patients undergoing elective PCI, with normal baseline cardiac troponin-I (cTn-I) values, were randomized to two groups. Two patients were excluded due to data loss, and 102 patients were analyzed. Five minutes of ischemic preconditioning was delivered just before the intervention to the preconditioning group, by inflating the blood pressure cuff up to 200 mm Hg on the non-dominant arm. Postprocedural 16thhour cTn-I, ΔcTn-I (difference between the 16thh and baseline cTn-I values) and the prevalence of type 4a myocardial infarction were compared between the two groups.


RESULTS
Median cTn-I values after the procedure were compared. 16thhour cTn-I was insignificantly lower in the preconditioning arm (0.026 μg/l vs. 0.045 μg/l,p= 0.186). The incidence of cTn-I elevation 5-fold above the upper reference limit (URL) (> 0.115 μg/l) was lower in the preconditioning group, but it was also not significant (21.6% vs. 11.8%,p= 0.184).


CONCLUSIONS
A single episode of RIPC before elective PCI demonstrated less troponin elevation but failed to show a significant effect.
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Mustafa A
MA
Yılmaztepe
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Gökay
G
Taylan
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Meryem
M
Aktoz
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Hanefi Y
HY
Gürlertop
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Yüksel
Y
Aksoy
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Fatih
F
Özçelik
Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey.
Kenan
K
Yalta
Department of Public Health, School of Medicine, Trakya University, Edirne, Turkey.
Galip
G
Ekuklu
myocardial injury; percutaneous coronary intervention; remote ischemic preconditioning