Abstract
Background Contrast medium-induced acute kidney injury (CI-AKI) is a cardiovascular complication after myocardial infarction treated with emergency percutaneous coronary intervention. The aim of this randomized, sham-controlled trial was to evaluate the impact of remote ischemic preconditioning (RIPC) on CI-AKI in patients with ST-elevation myocardial infarction who received emergency primary percutaneous coronary intervention.
Methods and results Patients with a suspected ST-elevation myocardial infarction were randomly assigned at a 1:1 ratio to receive percutaneous coronary intervention either with (n = 63) or without (n = 62) RIPC (intermittent arm ischemia through three cycles of 5 min of inflation and 5 min of deflation of a blood pressure cuff). A total of 47 RIPC patients and 47 control patients met all study criteria. The primary endpoint was the incidence of CI-AKI, which was defined as an increase in serum creatinine > 0.5 mg/dL or > 25% over the baseline value 48-72 h after administration of contrast medium. The incidence of CI-AKI was 10% (n = 5) in the RIPC group and 36% (n = 17) in the control group (p = 0.003). The odds ratio of CI-AKI in patients who received RIPC was 0.18 (95% confidence interval: 0.05-0.64; p = 0.008).
Conclusions In patients with ST-elevation myocardial infarction, RIPC before percutaneous coronary intervention reduced the incidence of CI-AKI.
| Original language | English |
|---|---|
| Pages (from-to) | 136-141 |
| Number of pages | 6 |
| Journal | International Journal of Cardiology |
| Volume | 178 |
| DOIs | |
| Publication status | Published - Jan 15 2015 |
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Keywords
- Contrast media
- Myocardial infarction
- Percutaneous coronary intervention
- Renal failure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Medicine(all)
Cite this
Remote ischemic preconditioning reduces contrast-induced acute kidney injury in patients with ST-elevation myocardial infarction : A randomized controlled trial. / Yamanaka, Toshiaki; Kawai, Yusuke; Miyoshi, Toru; Mima, Tsutomu; Takagaki, Kenji; Tsukuda, Saori; Kazatani, Yukio; Nakamura, Kazufumi; Itoh, Hiroshi.
In: International Journal of Cardiology, Vol. 178, 15.01.2015, p. 136-141.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Remote ischemic preconditioning reduces contrast-induced acute kidney injury in patients with ST-elevation myocardial infarction
T2 - A randomized controlled trial
AU - Yamanaka, Toshiaki
AU - Kawai, Yusuke
AU - Miyoshi, Toru
AU - Mima, Tsutomu
AU - Takagaki, Kenji
AU - Tsukuda, Saori
AU - Kazatani, Yukio
AU - Nakamura, Kazufumi
AU - Itoh, Hiroshi
PY - 2015/1/15
Y1 - 2015/1/15
N2 - Background Contrast medium-induced acute kidney injury (CI-AKI) is a cardiovascular complication after myocardial infarction treated with emergency percutaneous coronary intervention. The aim of this randomized, sham-controlled trial was to evaluate the impact of remote ischemic preconditioning (RIPC) on CI-AKI in patients with ST-elevation myocardial infarction who received emergency primary percutaneous coronary intervention.Methods and results Patients with a suspected ST-elevation myocardial infarction were randomly assigned at a 1:1 ratio to receive percutaneous coronary intervention either with (n = 63) or without (n = 62) RIPC (intermittent arm ischemia through three cycles of 5 min of inflation and 5 min of deflation of a blood pressure cuff). A total of 47 RIPC patients and 47 control patients met all study criteria. The primary endpoint was the incidence of CI-AKI, which was defined as an increase in serum creatinine > 0.5 mg/dL or > 25% over the baseline value 48-72 h after administration of contrast medium. The incidence of CI-AKI was 10% (n = 5) in the RIPC group and 36% (n = 17) in the control group (p = 0.003). The odds ratio of CI-AKI in patients who received RIPC was 0.18 (95% confidence interval: 0.05-0.64; p = 0.008).Conclusions In patients with ST-elevation myocardial infarction, RIPC before percutaneous coronary intervention reduced the incidence of CI-AKI.
AB - Background Contrast medium-induced acute kidney injury (CI-AKI) is a cardiovascular complication after myocardial infarction treated with emergency percutaneous coronary intervention. The aim of this randomized, sham-controlled trial was to evaluate the impact of remote ischemic preconditioning (RIPC) on CI-AKI in patients with ST-elevation myocardial infarction who received emergency primary percutaneous coronary intervention.Methods and results Patients with a suspected ST-elevation myocardial infarction were randomly assigned at a 1:1 ratio to receive percutaneous coronary intervention either with (n = 63) or without (n = 62) RIPC (intermittent arm ischemia through three cycles of 5 min of inflation and 5 min of deflation of a blood pressure cuff). A total of 47 RIPC patients and 47 control patients met all study criteria. The primary endpoint was the incidence of CI-AKI, which was defined as an increase in serum creatinine > 0.5 mg/dL or > 25% over the baseline value 48-72 h after administration of contrast medium. The incidence of CI-AKI was 10% (n = 5) in the RIPC group and 36% (n = 17) in the control group (p = 0.003). The odds ratio of CI-AKI in patients who received RIPC was 0.18 (95% confidence interval: 0.05-0.64; p = 0.008).Conclusions In patients with ST-elevation myocardial infarction, RIPC before percutaneous coronary intervention reduced the incidence of CI-AKI.
KW - Contrast media
KW - Myocardial infarction
KW - Percutaneous coronary intervention
KW - Renal failure
UR - http://www.scopus.com/inward/record.url?scp=84916235914&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84916235914&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2014.10.135
DO - 10.1016/j.ijcard.2014.10.135
M3 - Article
VL - 178
SP - 136
EP - 141
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -