Remote ischemic preconditioning reduces contrast-induced acute kidney injury in patients with ST-elevation myocardial infarction: A randomized controlled trial

Toshiaki Yamanaka, Yusuke Kawai, Toru Miyoshi, Tsutomu Mima, Kenji Takagaki, Saori Tsukuda, Yukio Kazatani, Kazufumi Nakamura, Hiroshi Ito

Research output: Contribution to journalArticle

64 Citations (Scopus)

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 languageEnglish
Pages (from-to)136-141
Number of pages6
JournalInternational Journal of Cardiology
Volume178
DOIs
Publication statusPublished - Jan 15 2015

Keywords

  • Contrast media
  • Myocardial infarction
  • Percutaneous coronary intervention
  • Renal failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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