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 - Ito, Hiroshi
N1 - Publisher Copyright:
© 2014 Elsevier Ireland Ltd. All rights reserved.
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
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U2 - 10.1016/j.ijcard.2014.10.135
DO - 10.1016/j.ijcard.2014.10.135
M3 - Article
C2 - 25464237
AN - SCOPUS:84916235914
VL - 178
SP - 136
EP - 141
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -