Protective effect of remote ischemic preconditioning on myocardial damage after percutaneous coronary intervention in stable angina patients with complex coronary lesions ― Subanalysis of a randomized controlled trial

RINC Study Collaborators

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2 Citations (Scopus)

Abstract

Background: The effect of remote ischemic preconditioning (RIPC) on periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI) is controversial. The aim of this study was to investigate the effect of RIPC or intravenous nicorandil on pMD following elective PCI in a subgroup of patients with complex coronary lesions from a multicenter randomized controlled trial. Methods and Results: Patients with stable angina who underwent elective PCI were assigned to 3 groups: control, upper-limb RIPC or intravenous nicorandil. The major outcome was pMD incidence following PCI, with pMD defined as an elevated level of high-sensitivity cardiac troponin T or creatine kinase myocardial band at 12 or 24 h after PCI. A total of 171 patients with complex coronary lesions (ACC-AHA coronary classification type B2 or C) were analyzed. The incidence of pMD following PCI was significantly lower in the RIPC group than in the control group (44.4% vs. 66.1%; P=0.023). The adjusted odds ratio (95% confidence interval) for pMD in the RIPC vs. the controls was 0.41 (0.18−0.94). The incidence of pMD in the nicorandil group was not significantly reduced compared with the control groups. Conclusions: This substudy suggested that RIPC prior to PCI prevented pMD in patients with complex coronary lesions. Further investigation in a multicenter prospective study is needed to confirm these results.

Original languageEnglish
Pages (from-to)1788-1796
Number of pages9
JournalCirculation Journal
Volume82
Issue number7
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Myocardial Ischemic Preconditioning
Stable Angina
Ischemic Preconditioning
Percutaneous Coronary Intervention
Randomized Controlled Trials
Nicorandil
Control Groups
Incidence
MB Form Creatine Kinase
Troponin T
Upper Extremity
Multicenter Studies
Odds Ratio
Prospective Studies
Confidence Intervals

Keywords

  • Complex coronary lesions
  • Percutaneous coronary intervention
  • Periprocedural myocardial injury
  • Preconditioning

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{c661bd4a08c346c593f4fdf77b54e348,
title = "Protective effect of remote ischemic preconditioning on myocardial damage after percutaneous coronary intervention in stable angina patients with complex coronary lesions ― Subanalysis of a randomized controlled trial",
abstract = "Background: The effect of remote ischemic preconditioning (RIPC) on periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI) is controversial. The aim of this study was to investigate the effect of RIPC or intravenous nicorandil on pMD following elective PCI in a subgroup of patients with complex coronary lesions from a multicenter randomized controlled trial. Methods and Results: Patients with stable angina who underwent elective PCI were assigned to 3 groups: control, upper-limb RIPC or intravenous nicorandil. The major outcome was pMD incidence following PCI, with pMD defined as an elevated level of high-sensitivity cardiac troponin T or creatine kinase myocardial band at 12 or 24 h after PCI. A total of 171 patients with complex coronary lesions (ACC-AHA coronary classification type B2 or C) were analyzed. The incidence of pMD following PCI was significantly lower in the RIPC group than in the control group (44.4{\%} vs. 66.1{\%}; P=0.023). The adjusted odds ratio (95{\%} confidence interval) for pMD in the RIPC vs. the controls was 0.41 (0.18−0.94). The incidence of pMD in the nicorandil group was not significantly reduced compared with the control groups. Conclusions: This substudy suggested that RIPC prior to PCI prevented pMD in patients with complex coronary lesions. Further investigation in a multicenter prospective study is needed to confirm these results.",
keywords = "Complex coronary lesions, Percutaneous coronary intervention, Periprocedural myocardial injury, Preconditioning",
author = "{RINC Study Collaborators} and Kentaro Ejiri and Toru Miyoshi and Kunihisa Kohno and Makoto Nakahama and Masayuki Doi and Mitsuru Munemasa and Masaaki Murakami and Atsushi Takaishi and Kazufumi Nakamura and Hiroshi Itoh",
year = "2018",
month = "1",
day = "1",
doi = "10.1253/circj.CJ-17-1000",
language = "English",
volume = "82",
pages = "1788--1796",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "7",

}

TY - JOUR

T1 - Protective effect of remote ischemic preconditioning on myocardial damage after percutaneous coronary intervention in stable angina patients with complex coronary lesions ― Subanalysis of a randomized controlled trial

AU - RINC Study Collaborators

AU - Ejiri, Kentaro

AU - Miyoshi, Toru

AU - Kohno, Kunihisa

AU - Nakahama, Makoto

AU - Doi, Masayuki

AU - Munemasa, Mitsuru

AU - Murakami, Masaaki

AU - Takaishi, Atsushi

AU - Nakamura, Kazufumi

AU - Itoh, Hiroshi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The effect of remote ischemic preconditioning (RIPC) on periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI) is controversial. The aim of this study was to investigate the effect of RIPC or intravenous nicorandil on pMD following elective PCI in a subgroup of patients with complex coronary lesions from a multicenter randomized controlled trial. Methods and Results: Patients with stable angina who underwent elective PCI were assigned to 3 groups: control, upper-limb RIPC or intravenous nicorandil. The major outcome was pMD incidence following PCI, with pMD defined as an elevated level of high-sensitivity cardiac troponin T or creatine kinase myocardial band at 12 or 24 h after PCI. A total of 171 patients with complex coronary lesions (ACC-AHA coronary classification type B2 or C) were analyzed. The incidence of pMD following PCI was significantly lower in the RIPC group than in the control group (44.4% vs. 66.1%; P=0.023). The adjusted odds ratio (95% confidence interval) for pMD in the RIPC vs. the controls was 0.41 (0.18−0.94). The incidence of pMD in the nicorandil group was not significantly reduced compared with the control groups. Conclusions: This substudy suggested that RIPC prior to PCI prevented pMD in patients with complex coronary lesions. Further investigation in a multicenter prospective study is needed to confirm these results.

AB - Background: The effect of remote ischemic preconditioning (RIPC) on periprocedural myocardial damage (pMD) in patients undergoing percutaneous coronary intervention (PCI) is controversial. The aim of this study was to investigate the effect of RIPC or intravenous nicorandil on pMD following elective PCI in a subgroup of patients with complex coronary lesions from a multicenter randomized controlled trial. Methods and Results: Patients with stable angina who underwent elective PCI were assigned to 3 groups: control, upper-limb RIPC or intravenous nicorandil. The major outcome was pMD incidence following PCI, with pMD defined as an elevated level of high-sensitivity cardiac troponin T or creatine kinase myocardial band at 12 or 24 h after PCI. A total of 171 patients with complex coronary lesions (ACC-AHA coronary classification type B2 or C) were analyzed. The incidence of pMD following PCI was significantly lower in the RIPC group than in the control group (44.4% vs. 66.1%; P=0.023). The adjusted odds ratio (95% confidence interval) for pMD in the RIPC vs. the controls was 0.41 (0.18−0.94). The incidence of pMD in the nicorandil group was not significantly reduced compared with the control groups. Conclusions: This substudy suggested that RIPC prior to PCI prevented pMD in patients with complex coronary lesions. Further investigation in a multicenter prospective study is needed to confirm these results.

KW - Complex coronary lesions

KW - Percutaneous coronary intervention

KW - Periprocedural myocardial injury

KW - Preconditioning

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U2 - 10.1253/circj.CJ-17-1000

DO - 10.1253/circj.CJ-17-1000

M3 - Article

C2 - 29669963

AN - SCOPUS:85049005764

VL - 82

SP - 1788

EP - 1796

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 7

ER -