Effects of remote ischemic preconditioning on myocardial injury and endothelial function and prognosis after percutaneous coronary intervention in patients with acute coronary syndrome

• Published in: European review for medical and pharmacological sciences Vol. 21; no. 20; p. 4642
• Main Authors: Zhou, F-Z, Song, W, Yin, L-H, Song, Z-F, Yang, S, Yang, F-B, Liu, J-F, Song, Y-G, Zhang, H-Y, Zhang, Z-M
• Format: Journal Article
• Language: English
• Published: Italy 01.10.2017
• Subjects: Acute Coronary Syndrome - complications; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - surgery; Aged; Angina, Unstable - complications; Angina, Unstable - diagnosis; C-Reactive Protein - analysis; Coronary Vessels - physiology; Creatine Kinase, MB Form - blood; Female; Humans; Ischemic Preconditioning; Male; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - complications; Myocardial Infarction - diagnosis; Percutaneous Coronary Intervention - adverse effects; Prognosis; Prospective Studies; Treatment Outcome; Troponin I - blood; Vascular Cell Adhesion Molecule-1 - metabolism
• ISSN: 2284-0729

To explore the effects of remote ischemic preconditioning on myocardial injury and prognosis after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. The study was a single center, prospective, randomized, controlled study. A total of 184 patients with unstable angina undergoing elective PCI were randomly assigned to remote ischemic preconditioning group (induced by four times of 5-min inflations of a blood pressure cuff to 200 mmHg around the upper arm, followed by 5-min intervals of reperfusion at 1 h before PCI therapy) or control group (an uninflated cuff around the arm). Successful completion of the PCI eventually included 130 cases of patients, including 72 cases in the remote ischemic preconditioning group and 58 cases in the control group. CK-MB, cTnI, sICAM-1, sVCAM-1 and Hs-CRP levels were measured at 6 am. of the day operating PCI and at 24 h after PCI in the two groups. Major adverse cardiac events were recorded of two groups of patients in the postoperative 6 months. (MACE, including recurrence of angina pectoris, myocardial infarction and death). There were no statistically significant differences in baseline indicators between the 2 groups. CK - MB, cTnI, sICAM-1, sVCAM-1 and Hs-CRP levels in patients with remote ischemic preconditioning group were significantly lower than those form the control group after PCI (p < 0.05), but there were no significant differences between the occurrence of MACE in the postoperative 6 months (p > 0.05). Remote ischemic preconditioning can reduce PCI related myocardial injury and protect vascular endothelial function.